NPIMap

Individual provider Active NPI

Mohan Madhusudanan, M.D.

  • Specialist
  • Buffalo, NY
National Provider Identifier
1548308463
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
255870 Issued in NY
Practice address
3435 Bailey Ave
Buffalo, NY 14215-1145
Phone
(716) 835-2966
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD425581 PA
Specialist 174400000X 255870 NY Primary

Addresses

Primary practice location

3435 Bailey Ave
Buffalo, NY 14215-1145

Mailing address

3435 Bailey Ave
Buffalo, NY 14215-1145
Phone (716) 835-2966

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
I20100823000897 NY Practitioner - Internal Medicine 4587798871 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers School of Dental Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Wny PCGroup PAC ID 5193907517, 207 clinicians
Kenmore Mercy HospitalGroup PAC ID 7517870462, 54 clinicians
Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

1616 Kensington Ave
Suite 1
Buffalo, NY 14215-1433
Phone (716) 834-3278

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 837-2400

2605 Harlem Rd
Cheektowaga, NY 14225-4018
Phone (716) 891-2400

2950 Elmwood Ave
Kenmore, NY 14217-1304

3091 William St
Cheektowaga, NY 14227-1919
Phone (716) 822-3098

310 Sterling Dr
Suite 100
Orchard Park, NY 14127-1500
Phone (716) 677-6800

3435 Bailey Ave
Buffalo, NY 14215-1194
Phone (716) 835-2966

4855 Camp Rd
Hamburg, NY 14075-2600

5290 Military Rd
Suite 8
Lewiston, NY 14092-1953
Phone (716) 298-3000

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 297-4800

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 837-2400

6001 Shimer Dr
Lockport, NY 14094-6412
Phone (716) 342-3026

825 Wehrle Dr
Williamsville, NY 14221-7717
Phone (716) 634-3243

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255870NYMDSpecialist
MD425581PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Dec 7, 2010 Accepting new patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Jun 27, 2017 Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Current Accepting new patients
Kenmore Mercy Hospital CurrentSince Jun 27, 2017 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Dec 7, 2010 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Oct 1, 2015 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Trinity Medical Wny PC Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Kenmore Mercy Hospital CurrentSince Jun 27, 2017 Accepting new patients
Mount St. Mary's Hospital of Niagara Falls Internal Medicine CurrentSince Jun 27, 2017 Accepting new patients
Trinity Medical Wny PC CurrentSince Jan 1, 2017 Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients

Locations

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

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

565 Abbott Rd
#2
Buffalo, NY 14220

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

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

3091 William St
Cheektowaga, NY 14227
Phone (716) 822-3098

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

300 Two Mile Creek Rd
Tonawanda, NY 14150
Phone (716) 447-6450

Interoperability endpoints

  • Direct secure messaging: mmadhusudanan110619@direct.chsbuffalo.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 11

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1548308463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADHUSUDANAN",
        "first_name": "MOHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD425581",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "255870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.