Individual provider Active NPI

Stanley James Pietrak, M.D.

  • Gastroenterology Physician
  • Williamsville, NY
National Provider Identifier
1396794939
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
143423 Issued in NY
Practice address
60 Maple Rd
Williamsville, NY 14221-2917
Phone
(716) 626-5250
Fax
(716) 332-2218
NPI assigned
May 10, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 143423 NY Primary

Addresses

Primary practice location

60 Maple Rd
Williamsville, NY 14221-2917

Mailing address

60 Maple Rd
Williamsville, NY 14221-2917
Phone (716) 626-5250

Other identifiers 1

IdentifierTypeStateIssuer
00845969MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080212000478 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 6709863244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Albany Medical College of Union University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates LLPGroup PAC ID 8820048085, 28 clinicians

Practice addresses (Care Compare)

60 Maple Rd
Suite 1
Williamsville, NY 14221-2917
Phone (716) 626-5250

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy162
Upper gastrointestinal (GI) endoscopy for acid reflux88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates, LLP Gastroenterology CurrentSince Mar 1, 2008 Accepting new patients
Gastrointestinal Group Gastroenterology PastSince Mar 1, 2008 Accepting new patients

Locations

6935 Elaine Dr
Niagara Falls, NY 14304
Phone (716) 626-5250

60 Maple Rd
#1
Williamsville, NY 14221
Phone (716) 626-5250

Interoperability endpoints

  • Direct secure messaging: spietrak@gastrowny.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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1396794939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRAK",
        "first_name": "STANLEY",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "143423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00845969",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.