Individual provider Active NPI

Connor Essenburg

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1316684673
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028434 Issued in NY
Practice address
3925 Sheridan Dr
Amherst, NY 14226-1738
Phone
(716) 250-9999
NPI assigned
May 18, 2022
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028434 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3925 Sheridan Dr
Amherst, NY 14226-1738

Mailing address

1721 Eddy Dr
North Tonawanda, NY 14120-3085
Phone (716) 909-0782

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823000254 NY Practitioner - Physician Assistant 1759764897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

10195 Niagara Falls Blvd
Suite 100
Niagara Falls, NY 14304-2941
Phone (716) 250-9999

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

8750 Transit Rd
East Amherst, NY 14051-2610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
89.94
Promoting interoperability
88
Improvement activities
40
Cost
82.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Jul 1, 2022 Accepting new patients
Excelsior Orthopaedics LLP Single Specialty CurrentSince Jul 1, 2022 Accepting new patients

Locations

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

10195 Niagara Falls Blvd
#100
Niagara Falls, NY 14304

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

Interoperability endpoints

  • Direct secure messaging: cessenberg@excelsiorortho.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1316684673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 EDDY DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141203085",
            "telephone_number": "716-909-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSENBURG",
        "first_name": "CONNOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028434",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.