Individual provider Active NPI

Andrew McCulloch

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1508253899
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
265829 Issued in NY
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 836-7510
NPI assigned
Apr 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 265829 NY Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

3871 Harlem Rd Ste 202
Buffalo, NY 14215-1946
Phone (716) 836-7510

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
I20190726000908 NY Practitioner - Anesthesiology 4385981794 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northtowns Ambulatory Surgery Center, LLC CurrentSince Sep 10, 2024 Accepting new patients
Parkside Medical Anesthesia Associates Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients

Locations

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

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

111 N Maplemere Rd
Williamsville, NY 14221
Phone (716) 713-4310

Organizations & group practices 2

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": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1508253899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 HARLEM RD STE 202",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151946",
            "telephone_number": "716-836-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-836-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "265829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.