Individual provider Active NPI

Philip R Niswander, M.D.

  • Ophthalmology Physician
  • Williamsville, NY
National Provider Identifier
1306844550
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
142714 Issued in NY
Practice address
40 N Union Rd
Niswander Eye Center
Williamsville, NY 14221-5339
Phone
(716) 634-4441
Fax
(716) 634-3174
NPI assigned
Jul 12, 2005
Reactivated
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 142714 NY Primary

Addresses

Primary practice location

40 N Union Rd
Niswander Eye Center
Williamsville, NY 14221-5339

Mailing address

40 N Union Rd
Williamsville, NY 14221-5339
Phone (716) 634-4441

Other identifiers 1

IdentifierTypeStateIssuer
00766289MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000438 NY Practitioner - Ophthalmology 8921070046 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Williamsville, NY

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Ophthalmology and Cataract Care, PLLC CurrentSince Jun 1, 1983 Accepting new patients
Visionary Ophthalmology and Cataract Care, PLLC Ophthalmology CurrentSince Oct 21, 2021 Accepting new patients
Ambulatory Surgery Center of Wny PastSince Jan 1, 1999 Accepting new patients

Locations

40 N Union Rd
Williamsville, NY 14221
Phone (716) 631-3950

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/vo90cc71

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1306844550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215339",
            "telephone_number": "716-634-4441",
            "fax_number": "716-634-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N UNION RD",
            "address_2": "NISWANDER EYE CENTER",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215339",
            "telephone_number": "716-634-4441",
            "fax_number": "716-634-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISWANDER",
        "first_name": "PHILIP",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "142714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00766289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.