Maxwell Boasiako Antwi
Individual provider Active NPI Nurse Practitioner · Williamsville, NY
NPI 1336770718 · NPPES record last updated Feb 7, 2023
Key facts
- NPI
- 1336770718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 309224 (NY)
- Practice address
- 40 George Karl Blvd
Williamsville, NY 14221-7183 - Phone
- (716) 218-1000
- Fax
- (716) 923-4384
- NPI assigned
- Feb 4, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Wny Medical PC
Practice addresses (Care Compare)
4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200707002710 | NY | Practitioner - Nurse Practitioner | 1456774694 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University at Buffalo Neurosurgery, Inc. | Current |
Accepting new patients | |
| University at Buffalo Neurosurgery, Inc. | Current |
Accepting new patients | |
| Wny Medical PC | Nurse Practitioner | Current |
Accepting new patients |
Locations
4979 Harlem Rd
Buffalo, NY 14226
Phone (716) 923-4380
100 High St
Buffalo, NY 14203
Phone (716) 632-3700
875 Ellicott St
Buffalo, NY 14203
Phone (716) 748-2000
3884 Broadway St
Cheektowaga, NY 14227
Phone (716) 681-9000
40 George Karl Blvd
Williamsville, NY 14221
Phone (716) 539-0888
40 George Karl Blvd
Ste 200
Williamsville, NY 14221
Phone (716) 200-1800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 309224 | NY | |
| Nurse Practitioner | 363L00000X | 309224 | NY | Yes |
Addresses
Primary practice location
40 George Karl Blvd
Williamsville, NY 14221-7183
Mailing address
4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4381
Other providers in Williamsville, NY
- Anne Anstead Anstead
- Matthew Antalek
- Moira Grace Antalek
- Kenneth David Anthone
- Anthony M. Leone, MD, PC
- Stephen Tofano Anzalone
- Melissa Apa
- Apnea Care Inc.
- Kevin M. Apolito
- Applegate Dental
All providers in Williamsville, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.