NPIMap

Individual provider Active NPI

David M Erickson, MD

  • Family Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1508363664
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
318722 Issued in NY
Practice address
3671 Southwestern Blvd
St 101
Orchard Park, NY 14127-1749
Phone
(716) 662-7008
Fax
(716) 662-5226
NPI assigned
Apr 6, 2018
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 318722 NY Primary

Addresses

Primary practice location

3671 Southwestern Blvd
St 101
Orchard Park, NY 14127-1749

Mailing address

3671 Southwestern Blvd
St 101
Orchard Park, NY 14127-1749
Phone (716) 662-7008

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
I20221006000663 NY Practitioner - Family Practice 1254678717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Robert Erickson DO and Jennifer Erickson DO LLCGroup PAC ID 5991748626, 13 clinicians

Practice addresses (Care Compare)

3671 Southwestern Blvd
Suite 101
Orchard Park, NY 14127-1749
Phone (716) 662-7008

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318722NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Erickson DO and Jennifer Erickson DO LLC CurrentSince Oct 17, 2022 Accepting new patients
Robert Erickson DO and Jennifer Erickson DO LLC Family Medicine CurrentSince Oct 17, 2022 Accepting new patients

Locations

3671 Southwestern Blvd
Ste 101
Orchard Park, NY 14127
Phone (716) 662-7008

Interoperability endpoints

  • Direct secure messaging: derickson@familypractice.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1508363664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD",
            "address_2": "ST 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD",
            "address_2": "ST 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "318722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.