Individual provider Active NPI

Nicholas Peter Bossert

  • Medical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1538711767
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
023593 Issued in NY
Practice address
6255 Sheridan Dr Ste 200
Williamsville, NY 14221-8096
Phone
(716) 636-7979
Fax
(716) 929-0192
NPI assigned
Jul 9, 2019
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023593 NY
Medical Physician Assistant 363AM0700X 023593 NY Primary

Addresses

Primary practice location

6255 Sheridan Dr Ste 200
Williamsville, NY 14221-8096

Mailing address

6255 Sheridan Dr Ste 200
Williamsville, NY 14221-8096
Phone (716) 636-7979

Other identifiers 1

IdentifierTypeStateIssuer
05764672MedicaidNY

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
I20190801000409 NY Practitioner - Physician Assistant 4789910589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Highgate Medical Group PCGroup PAC ID 6901885565, 58 clinicians

Practice addresses (Care Compare)

6255 Sheridan Dr
Suite 200
Williamsville, NY 14221-4825
Phone (716) 636-7979

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023593NYMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Highgate Medical Group CurrentSince Apr 27, 2026 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jul 18, 2019 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jul 18, 2019 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

6255 Sheridan Dr
Ste 200
Williamsville, NY 14221
Phone (716) 636-7979

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

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1538711767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218096",
            "telephone_number": "716-636-7979",
            "fax_number": "716-929-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 SHERIDAN DR STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218096",
            "telephone_number": "716-636-7979",
            "fax_number": "716-929-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERT",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-09",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023593",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05764672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.