Individual provider Active NPI

Samuel Joshua Rothman, MD

  • Psychiatry Physician
  • Buffalo, NY
National Provider Identifier
1467940957
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
325466 Issued in NY
Practice address
1569 Niagara St
Buffalo, NY 14213-1101
Phone
(716) 427-7000
NPI assigned
Apr 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 325466 NY Primary

Addresses

Primary practice location

1569 Niagara St
Buffalo, NY 14213-1101

Mailing address

155 Lawn Ave
Buffalo, NY 14207-1816

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
I20240807001790 NY Practitioner - Psychiatry 6002153467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Health Center of Wny, Inc.Group PAC ID 5193794972, 52 clinicians

Practice addresses (Care Compare)

155 Lawn Ave
Buffalo, NY 14207-1816
Phone (716) 875-2904

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Center of Wny, Inc. CurrentSince Jul 25, 2024 Accepting new patients
Neighborhood Health Center of Wny, Inc. CurrentSince Jul 25, 2024 Accepting new patients
Terrell Tiny Teeth PLLC Past Accepting new patients

Locations

1569 Niagara St
Buffalo, NY 14213
Phone (716) 427-7000

300 Niagara St
Buffalo, NY 14201
Phone (716) 242-8600

4233 Lake Ave
Buffalo, NY 14219
Phone (716) 332-3070

155 Lawn Ave
Buffalo, NY 14207
Phone (716) 875-2904

151 Elmview Ave
Hamburg, NY 14075
Phone (716) 648-3040

Interoperability endpoints

  • Direct secure messaging: samuel.rothman.1@26491.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1467940957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 LAWN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131101",
            "telephone_number": "716-427-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "SAMUEL",
        "middle_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.