Individual provider Active NPI

Jean-Luc Claude Urbain, M.D., PH.D.

  • Nuclear Imaging & Therapy Physician
  • Buffalo, NY
National Provider Identifier
1548588759
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X
License
227633-1 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-5666
Phone
(716) 845-2300
NPI assigned
May 12, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X 35-07-9911-U OH
Nuclear Imaging & Therapy Physician 207UN0902X MD-052894-L PA
Nuclear Radiology Physician 2085N0904X 2018-00210 NC
Nuclear Imaging & Therapy Physician 207UN0902X 227633-1 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-5666

Mailing address

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180403001892 NC Practitioner - Nuclear Medicine 5395007371 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227633-1NYMDNuclear Imaging & Therapy Physician
MD-052894-LPAMDNuclear Imaging & Therapy Physician
2018-00210NCMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Jan 2, 2023 Accepting new patients
Wake Forest Baptist Imaging, LLC CurrentSince Apr 1, 2018 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jan 2, 2023 Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients

Locations

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

Organizations & group practices 5

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1548588759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142635666",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAIN",
        "first_name": "JEAN-LUC",
        "middle_name": "CLAUDE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "OH",
            "license": "35-07-9911-U",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "PA",
            "license": "MD-052894-L",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NC",
            "license": "2018-00210",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "NY",
            "license": "227633-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.