Individual provider Active NPI

Andrew M Dybalski, RPA-C

  • Surgical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1386626117
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
009369 Issued in NY
Practice address
700 Michigan Ave
Buffalo, NY 14203-1514
Phone
(716) 854-5700
Fax
(716) 854-5800
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 009369 NY Primary

Addresses

Primary practice location

700 Michigan Ave
Buffalo, NY 14203-1514

Mailing address

4225 Genesee St Ste 400
Cheektowaga, NY 14225-1994
Phone (716) 204-3200

Other practice location 1

4949 Harlem Rd
Amherst, NY 14226-2500
Phone (716) 204-3200

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
I20040526001182 NY Practitioner - Physician Assistant 2769463637 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

700 Michigan Ave
Buffalo, NY 14203-1536

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as group
Quality
77.6
Promoting interoperability
100
Improvement activities
40
Cost
81.28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Neurosurgery, Inc. CurrentSince Jul 1, 2020 Accepting new patients
University at Buffalo Neurosurgery, Inc. CurrentSince Jul 1, 2020 Accepting new patients
University Orthopaedic Services Inc. CurrentSince Feb 22, 2021 Accepting new patients
University Orthopaedic Services, Inc CurrentSince Feb 22, 2021 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

4949 Harlem Rd
Buffalo, NY 14226
Phone (716) 204-3201

160 Farber Hall
Buffalo, NY 14214
Phone (716) 829-2070

4225 Genesee St
Ste 400
Cheektowaga, NY 14225
Phone (716) 906-5905

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1386626117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GENESEE ST STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251994",
            "telephone_number": "716-204-3200",
            "fax_number": "716-204-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MICHIGAN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031514",
            "telephone_number": "716-854-5700",
            "fax_number": "716-854-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4949 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142262500",
            "country_code": "US",
            "telephone_number": "716-204-3200",
            "fax_number": "716-204-4337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYBALSKI",
        "first_name": "ANDREW",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.