Individual provider Active NPI

Paul Brian Hart, MD

  • Internal Medicine Physician
  • Tonawanda, NY
National Provider Identifier
1417000829
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
186744-1 Issued in NY
Practice address
533 Niagara St
Tonawanda, NY 14150-1810
Phone
(716) 743-5450
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 186744-1 NY Primary

Addresses

Primary practice location

533 Niagara St
Tonawanda, NY 14150-1810

Mailing address

159 Brandywine Dr
Williamsville, NY 14221-1876
Phone (716) 639-0567

Other identifiers 3

IdentifierTypeStateIssuer
000523958002OtherNYBLUE CROSS
3007674OtherNYINDEPENDENT HEALTH
00020008602OtherNYUNIVERA

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
I20071213000664 NY Practitioner - Physical Medicine and RehabilitationPractitioner - Internal Medicine 3173613155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186744-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center CurrentSince Jun 4, 2024 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jun 4, 2024 Accepting new patients

Locations

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1417000829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BRANDYWINE DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211876",
            "telephone_number": "716-639-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 NIAGARA ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141501810",
            "telephone_number": "716-743-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "PAUL",
        "middle_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "186744-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000523958002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "3007674",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020008602",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.