Individual provider Active NPI

Jenna Marie Gage, DO

  • Diagnostic Radiology Physician
  • Williamsville, NY
National Provider Identifier
1417105735
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0102206016 Issued in VA
Practice address
325 Essjay Rd
Williamsville, NY 14221-8243
Phone
(716) 630-1112
Fax
(716) 631-0584
NPI assigned
Aug 28, 2008
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0102206016 VA Primary

Addresses

Primary practice location

325 Essjay Rd
Williamsville, NY 14221-8243

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363
Phone (434) 924-9333

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com Buffalo Medical Group, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200710000753 VA Practitioner - Diagnostic Radiology 8729401690 Reassigns benefits to 2 organizations
I20210607000270 NY Practitioner - Diagnostic Radiology 8729401690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

325 Essjay Rd
Williamsville, NY 14221-8243
Phone (716) 630-1000

Merit-based Incentive Payment System (MIPS)

Final score
91.31 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
83.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102206016VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jun 25, 2020 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology CurrentSince Jun 15, 2020 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology CurrentSince Jun 15, 2020 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jun 2, 2021 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jun 2, 2021 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

1300 Jefferson Park Ave
Fl 4
Charlottesville, VA 22903
Phone (434) 924-5078

415 Ray C Hunt Dr
#1100
Charlottesville, VA 22903
Phone (434) 243-8189

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

545 Ray C Hunt Dr
Ste 140
Charlottesvle, VA 22903
Phone (434) 243-9198

Interoperability endpoints

  • Direct secure messaging: production@direct.buffalomedicalgroup.com

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, 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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1417105735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218243",
            "telephone_number": "716-630-1112",
            "fax_number": "716-631-0584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Jefferson Park Ave",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229033363",
            "country_code": "US",
            "telephone_number": "434-924-9333",
            "fax_number": "434-924-5672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGE",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0102206016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "Y",
            "affiliationName": "Buffalo Medical Group, P.C.",
            "address_1": "325 Essjay Rd",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142218243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.