Individual provider Active NPI

Ronald G Palazzo, MD

  • Family Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1437157609
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
191121 Issued in NY
Practice address
3671 Southwestern Blvd
Suite 109
Orchard Park, NY 14127-1752
Phone
(716) 662-9045
Fax
(716) 662-9012
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 191121 NY Primary

Addresses

Primary practice location

3671 Southwestern Blvd
Suite 109
Orchard Park, NY 14127-1752

Mailing address

3671 Southwestern Blvd
Suite 109
Orchard Park, NY 14127-1752
Phone (716) 662-9045

Other identifiers 4

IdentifierTypeStateIssuer
00010132803OtherNYUNIVERA
005230102OtherNYBLUE CROSS SHIELD WNY
0105633OtherNYINDEPENDENT HEALTH
01782190MedicaidNY

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
I20100201000180 NY Practitioner - Family Practice 5890838783

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3671 Southwestern Blvd
Orchard Park, NY 14127-1752

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191121NYMDFamily Medicine Physician

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1437157609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD",
            "address_2": "SUITE 109",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271752",
            "telephone_number": "716-662-9045",
            "fax_number": "716-662-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD",
            "address_2": "SUITE 109",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271752",
            "telephone_number": "716-662-9045",
            "fax_number": "716-662-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZO",
        "first_name": "RONALD",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "191121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010132803",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD WNY",
            "identifier": "005230102",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0105633",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01782190",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.