NPIMap

Organization Active NPI

Mercy Hospital of Buffalo

  • Hospitalist Physician
  • Buffalo, NY
National Provider Identifier
1508159179
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
MERCY HOSPITAL OF BUFFALO
Practice address
565 Abbott Rd
Buffalo, NY 14220-2039
Phone
(716) 828-2008
NPI assigned
May 16, 2011
Last updated
Nov 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HOSPITAL OF BUFFALOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Charles J. Urlaub
Title
Ceo/President
Phone
(716) 828-2008

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NY
Hospitalist Physician 208M00000X NY Primary

Addresses

Primary practice location

565 Abbott Rd
Buffalo, NY 14220-2039

Mailing address

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 828-2008

Other identifiers 1

IdentifierTypeStateIssuer
03388534MedicaidNY

Other names 1

  • Mercy Hospitalist Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702001253 NY Part B Supplier - Clinic/Group Practice 8729991666 Receives reassigned benefits from 632 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Seneca, NY; Springville, NY; Orchard Park, NY; Lackawanna, NY; Buffalo, NY; Kenmore, NY; East Aurora, NY; Cheektowaga, NY

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Mercy Hospital-Int Med

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1508159179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142202039",
            "telephone_number": "716-828-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142202039",
            "telephone_number": "716-828-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL OF BUFFALO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITAL OF BUFFALO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "URLAUB",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "716-828-2008"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03388534",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Hospitalist Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.