NPIMap

Individual provider Active NPI

Winston George Douglas, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1548297328
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
208258-1 Issued in NY
Practice address
840 Humboldt Pkwy
Buffalo, NY 14211-1217
Phone
(716) 884-8033
Fax
(716) 884-8036
NPI assigned
Jun 27, 2006
Last updated
Apr 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 208258-1 NY Primary

Addresses

Primary practice location

840 Humboldt Pkwy
Buffalo, NY 14211-1217

Mailing address

840 Humboldt Pkwy
Buffalo, NY 14211-1217
Phone (716) 884-8033

Other identifiers 5

IdentifierTypeStateIssuer
00010311504OtherNYUNIVERA
000524891004OtherNYBLUECROSS BLUESHIELD
P00052855OtherNYMEDICARE RAIL ROAD
01804580MedicaidNY
0409592OtherNYINDEPENDENT HEALTH

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
I20040422000181 NY Practitioner - Internal Medicine 6204822554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winston G Douglas MD PCGroup PAC ID 5799967949, 2 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

755 Wehrle Dr
Buffalo, NY 14225-1319
Phone (716) 884-8033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208258-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winston G Douglas MD PC CurrentSince Jun 10, 2010 Accepting new patients
WG Medical PLLC PastSince Jan 1, 1990 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

700 Michigan Ave
Ste 210
Buffalo, NY 14203
Phone (716) 853-2225

840 Humboldt Pkwy
Buffalo, NY 14211
Phone (716) 884-8033

755 Wehrle Dr
Cheektowaga, NY 14225
Phone (716) 634-0600

Interoperability endpoints

  • Direct secure messaging: drdouglas@winstondouglasmdpc.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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1548297328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HUMBOLDT PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142111217",
            "telephone_number": "716-884-8033",
            "fax_number": "716-884-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HUMBOLDT PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142111217",
            "telephone_number": "716-884-8033",
            "fax_number": "716-884-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WINSTON",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208258-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010311504",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "000524891004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P00052855",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01804580",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0409592",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.