NPIMap

Individual provider Active NPI

Jeffrey W Berndtson, M.D.

  • Surgery Physician
  • Orchard Park, NY
National Provider Identifier
1457340689
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
224211 Issued in NY
Practice address
3345 Southwestern Blvd
Orchard Park, NY 14127-1506
Phone
(716) 656-4826
Fax
(716) 250-5981
NPI assigned
Oct 20, 2005
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 224211 NY Primary

Addresses

Primary practice location

3345 Southwestern Blvd
Orchard Park, NY 14127-1506

Mailing address

6255 Sheridan Dr
Ste 108
Williamsville, NY 14221-4825
Phone (716) 630-1219

Other practice location 1

1208 Niagara Falls Blvd
Tonawanda, NY 14150-8924
Phone (716) 833-7112

Other identifiers 1

IdentifierTypeStateIssuer
02280404MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000399 NY Practitioner - General Surgery 1456300029 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University at Buffalo Surgeons IncGroup PAC ID 4183612799, 40 clinicians

Practice addresses (Care Compare)

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 568-3600

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-5600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Hernia repair - groin (open)16
Hernia repair (minimally invasive)18
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224211NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jan 27, 2020 Accepting new patients
University at Buffalo Surgeons Inc Surgery CurrentSince Mar 1, 2019 Accepting new patients
Buffalo Medical Group, P.C. Surgery CurrentSince Sep 1, 2012 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2012 Accepting new patients
Kaleida Health Past Accepting new patients
Genesee Valley Group Health Association Past Accepting new patients
Western New York Ear, Nose & Throat, P.C. PastSince Jul 24, 2025 Accepting new patients
Frontier Surgical Associates, LLP Surgery PastSince Apr 30, 2003 Accepting new patients

Locations

515 Abbott Rd
Buffalo, NY 14220
Phone (716) 827-8220

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

899 Main St
Buffalo, NY 14203
Phone (716) 862-6544

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

3345 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 656-4825

1208 Niagara Falls Blvd
Tonawanda, NY 14150
Phone (716) 833-2200

6255 Sheridan Dr
Williamsville, NY 14221
Phone (716) 630-2582

6255 Sheridan Dr
Ste 108
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • Direct secure messaging: jeffreyberndtson@ubmd.allscriptsdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1457340689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR",
            "address_2": "STE 108",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214825",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271506",
            "telephone_number": "716-656-4826",
            "fax_number": "716-250-5981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 Niagara Falls Blvd",
            "address_purpose": "LOCATION",
            "city": "Tonawanda",
            "state": "NY",
            "postal_code": "141508924",
            "country_code": "US",
            "telephone_number": "716-833-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNDTSON",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "224211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02280404",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.