Organization Active NPI

Northtowns Psychiatry PC

  • Mental Illness Community Based Residential Treatment Facility
  • Tonawanda, NY
National Provider Identifier
1407003890
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
196919 Issued in NY
Legal business name
NORTHTOWNS PSYCHIATRY PC
Practice address
479 Englewood Ave
Northtowns Psychiatry PC
Tonawanda, NY 14223-2862
Phone
(716) 831-9030
Fax
(716) 831-9075
NPI assigned
Aug 27, 2008
Last updated
Aug 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. Michael S Mogerman, M.D.NPI 1457305773
Title
Officer
Phone
(716) 831-9030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 196919 NY Primary

Addresses

Primary practice location

479 Englewood Ave
Northtowns Psychiatry PC
Tonawanda, NY 14223-2862

Mailing address

479 Englewood Ave
Tonawanda, NY 14223-2862
Phone (716) 831-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081107000453 NY Part B Supplier - Clinic/Group Practice 2466511225 Receives reassigned benefits from 1 practitioner
Practice locations: Williamsville, NY

National Provider Directory

National Provider Directory

Locations

479 Englewood Ave
Town of Tonawanda, NY 14223
Phone (716) 831-9030

5500 Main St
Ste 311
Williamsville, NY 14221
Phone (716) 831-9030

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1407003890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 ENGLEWOOD AVE",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142232862",
            "telephone_number": "716-831-9030",
            "fax_number": "716-831-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 ENGLEWOOD AVE",
            "address_2": "NORTHTOWNS PSYCHIATRY PC",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142232862",
            "telephone_number": "716-831-9030",
            "fax_number": "716-831-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHTOWNS PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "MOGERMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "716-831-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NY",
            "license": "196919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.