Individual provider Active NPI

John E. Czajkowski, PA

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1376841676
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014651 Issued in NY
Practice address
100 College Pkwy
Ste 100
Williamsville, NY 14221-6800
Phone
(716) 626-0093
NPI assigned
Mar 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014651 NY Primary

Addresses

Primary practice location

100 College Pkwy
Ste 100
Williamsville, NY 14221-6800

Mailing address

4242 Ridge Lea Rd
Ste 26
Amherst, NY 14226-5120
Phone (716) 833-3237

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
I20110429000393 NY Practitioner - Physician Assistant 2062697394 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014651NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Jun 20, 2012 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
Buffalo Spine & Sports Medicine PC Past Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

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

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Organizations & group practices 6

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": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1376841676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 RIDGE LEA RD",
            "address_2": "STE 26",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142265120",
            "telephone_number": "716-833-3237",
            "fax_number": "888-976-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY",
            "address_2": "STE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216800",
            "telephone_number": "716-626-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAJKOWSKI",
        "first_name": "JOHN",
        "middle_name": "E.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-10",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.