Individual provider Active NPI

Brooke Kolber

  • General Practice Dentistry
  • Buffalo, NY
National Provider Identifier
1316471287
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060037 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-1686
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060037 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

462 Grider St
Buffalo, NY 14215-3021

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191212002167 NY Practitioner - Dentist 7517390107 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060037NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Oct 19, 2019 Accepting new patients
Erie County Medical Center Corporation CurrentSince Oct 19, 2019 Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1316471287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBER",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.