Bradford Perham Mersereau

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

172072 Issued in NY

Practice address

3495 Bailey Ave
Primary Care Group 2
Buffalo, NY 14215-1129

Phone

(716) 862-3641

NPI assigned

Nov 14, 2005

Last updated

Dec 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1447231741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "address_2": "PRIMARY CARE GROUP 2",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-862-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "address_2": "PRIMARY CARE GROUP 2",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-862-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERSEREAU",
        "first_name": "BRADFORD",
        "middle_name": "PERHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "172072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Merrell, MS
• Michael D Merrill, MD
• Natalie Merriman, M.A., CCC-SLP
• Elizabeth Merritt
• Denisha Merriweather
• Kathleen Mertz, BA
• Renee Caroline Mertz, PMHNP-BC
• Mihai Merzianu, MD
• Moustafa M Mesha
• Rachel Manugas Mesina, PHARMD

• Family Medicine Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.