Individual provider Active NPI

John Richard Santillo III, D.O.

  • Emergency Medicine Physician
  • Buffalo, NY
National Provider Identifier
1447437876
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
257053 Issued in NY
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 862-1820
NPI assigned
Jan 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L1642312 MI
Emergency Medicine Physician 207P00000X 257053 NY Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

1 John James Audubon Pkwy
Buffalo, NY 14228-1143

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
I20100929000391 NY Practitioner - Emergency Medicine 9739205550 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1642312MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Aug 1, 2010 Accepting new patients
Keystone Medical Services of New York, PC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Medical Services of Buffalo, PC CurrentSince Sep 1, 2021 Accepting new patients
Exigence Medical of Hornell, PLLC Emergency Medicine Past Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine Past Accepting new patients

Locations

1 John James Audubon Pkwy
Buffalo, NY 14228
Phone (865) 985-7024

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

521 East Ave
Lockport, NY 14094
Phone (716) 434-9111

224 E Main St
Springville, NY 14141
Phone (716) 592-2871

6075 Poplar Ave
Ste 401
Memphis, TN 38119
Phone (901) 795-3600

Organizations & group practices 5

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": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1447437876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JOHN JAMES AUDUBON PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142281143"
        },
        {
            "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": "716-862-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLO",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "L1642312",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "257053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.