NPIMap

Individual provider Active NPI

Joshua Laird Carpenter, P.A.C.

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1396190450
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019652 Issued in NY
Practice address
40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 019652 NY Primary

Addresses

Primary practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344

Mailing address

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone (716) 893-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160721002006 NY Practitioner - Physician Assistant 0042503500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Mobile Medical Care PCGroup PAC ID 8426575325, 97 clinicians
Mobile Physician Services PLLCGroup PAC ID 8325360290, 104 clinicians

Practice addresses (Care Compare)

Buffalo, NY 14202
Phone (716) 893-1010

2365 Union Rd
Cheektowaga, NY 14227-2234
Phone (716) 668-8100

4650 Southwestern Blvd
Hamburg, NY 14075-1939
Phone (716) 648-2450

580 Orchard Park Rd
West Seneca, NY 14224-2600
Phone (716) 677-4242

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Ultrasound, Idtf Inc Past Accepting new patients
Geriatric Associates, LLP Past Accepting new patients
Mobile Primary Care Family Nurse Practitioners, PLLC PastSince Jun 1, 2007 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jcarpenter@mobileprimarycare.medentdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1396190450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1101",
            "fax_number": "716-893-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JOSHUA",
        "middle_name": "LAIRD",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.