Individual provider Active NPI

Jessie F Donaldson, PA

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1508098542
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013512 Issued in NY
Practice address
462 Grider St
Dept of Surgery St - Miller BLDG.
Buffalo, NY 14215-3021
Phone
(716) 898-5186
Fax
(716) 898-3194
NPI assigned
Aug 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013512 NY Primary

Addresses

Primary practice location

462 Grider St
Dept of Surgery St - Miller BLDG.
Buffalo, NY 14215-3021

Mailing address

PO Box 8000 Dept 313
University at Buffalo Surgeons, Inc.
Buffalo, NY 14267-0002
Phone (716) 888-4889

Other identifiers 1

IdentifierTypeStateIssuer
03156296MedicaidNY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091112000469 NY Practitioner - Physician Assistant 7719025659 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Apr 12, 2025 Accepting new patients
Erie County Medical Center Corporation CurrentSince Apr 12, 2025 Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients

Locations

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

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

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

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

705 Maple Rd
Ste 300
Williamsville, NY 14221
Phone (716) 631-8400

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.

Hospital & facility affiliations 1

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": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1508098542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000 DEPT 313",
            "address_2": "UNIVERSITY AT BUFFALO SURGEONS, INC.",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "716-888-4889",
            "fax_number": "716-849-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "address_2": "DEPT OF SURGERY ST - MILLER BLDG.",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-5186",
            "fax_number": "716-898-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "JESSIE",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03156296",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.