Individual provider Active NPI

Shanley Blackley Sifain, MD

  • Neonatal-Perinatal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1427357938
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
62287 Issued in TN
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 862-1000
NPI assigned
Mar 23, 2011
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 276535 NY
Neonatal-Perinatal Medicine Physician 2080N0001X 62287 TN Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-4600

Other practice location 1

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7000

Other practice location 2

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-4600

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
I20180126001684 NY Practitioner - Pediatric Medicine 2163782863 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276535NYMDPediatrics Physician
62287TNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Nov 21, 2017 Accepting new patients
Rochester General Hospital Pediatrics CurrentSince Nov 21, 2017 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 21, 2017 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 21, 2017 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 4

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1427357938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4600",
            "fax_number": "585-461-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-862-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264122",
            "country_code": "US",
            "telephone_number": "585-723-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-4600",
            "fax_number": "585-461-1231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIFAIN",
        "first_name": "SHANLEY",
        "middle_name": "BLACKLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "276535",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "62287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.