Individual provider Active NPI

Michael S Mogerman, MD

  • Psychiatry Physician
  • Williamsville, NY
National Provider Identifier
1457305773
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
196919 Issued in NY
Practice address
5500 Main St Ste 311
Williamsville, NY 14221-6753
Phone
(716) 831-9030
Fax
(716) 831-9075
NPI assigned
May 20, 2006
Last updated
May 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 196919 NY Primary

Addresses

Primary practice location

5500 Main St Ste 311
Williamsville, NY 14221-6753

Mailing address

PO Box 643
Amherst, NY 14226-0643
Phone (716) 831-9030

Other identifiers 1

IdentifierTypeStateIssuer
01557937MedicaidNY

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
I20050107000661 NY Practitioner - Psychiatry 1153379912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5500 Main St
Suite 311
Williamsville, NY 14221-6753
Phone (716) 831-9030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196919NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northtowns Psychiatry PC CurrentSince Aug 25, 2008 Accepting new patients
Niagara Frontier Psychiatric Associates Psychiatry Past Accepting new patients
University Psychiatric Practice, Inc Psychiatry PastSince Oct 1, 1992 Accepting new patients

Locations

479 Englewood Ave
Town of Tonawanda, NY 14223
Phone (716) 831-9030

5500 Main St
Ste 311
Williamsville, NY 14221
Phone (716) 831-9030

Organizations & group practices 3

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1457305773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142260643",
            "telephone_number": "716-831-9030",
            "fax_number": "716-831-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST STE 311",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216753",
            "telephone_number": "716-831-9030",
            "fax_number": "716-831-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGERMAN",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "196919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01557937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.