Individual provider Active NPI

Brendan Raleigh, M.D.

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1548674609
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
287526 Issued in NY
Practice address
77 Goodell St
Suites 220 and 240
Buffalo, NY 14203
Phone
(716) 816-7228
NPI assigned
Jun 17, 2014
Last updated
Mar 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 287526 NY Primary

Addresses

Primary practice location

77 Goodell St
Suites 220 and 240
Buffalo, NY 14203

Mailing address

184 Barton St
Buffalo, NY 14213-1573
Phone (716) 881-6191

Other practice location 1

77 Goodell St
Suites 220 and 240
Buffalo, NY 14203-1243
Phone (716) 816-7228

Other practice location 2

184 Barton St
Buffalo, NY 14213-1573
Phone (716) 881-6191

Other practice location 3

77 Goodell St
Suites 220 and 240
Buffalo, NY 14203-1243
Phone (716) 816-7228

Other practice location 4

2400 Pine Ave
Niagara Falls, NY 14301-2402
Phone (716) 505-1060

Other identifiers 1

IdentifierTypeStateIssuer
04879503MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180202000242 NY Practitioner - Family Practice 8729348180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizon Health Services IncGroup PAC ID 5698689925, 144 clinicians

Practice addresses (Care Compare)

2400 Pine Ave
Niagara Falls, NY 14301-2402
Phone (716) 505-1060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287526NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Services Inc CurrentSince Apr 2, 2020 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Oct 1, 2019 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Oct 1, 2019 Accepting new patients
Radiology Solutions Associates, PLLC PastSince Apr 21, 2020 Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

3020 Bailey Ave
Cheektowaga, NY 14215
Phone (716) 831-0200

55 Dodge Rd
Getzville, NY 14068
Phone (716) 650-5100

2400 Pine Ave
Niagara Falls, NY 14301
Phone (716) 282-1114

7616 Transit Rd
Williamsville, NY 14221
Phone (716) 204-2273

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 4

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1548674609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 BARTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131573",
            "telephone_number": "716-881-6191",
            "fax_number": "716-881-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GOODELL ST",
            "address_2": "SUITES 220 AND 240",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14203",
            "telephone_number": "716-816-7228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Goodell St",
            "address_2": "Suites 220 and 240",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031243",
            "country_code": "US",
            "telephone_number": "716-816-7228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "184 Barton St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142131573",
            "country_code": "US",
            "telephone_number": "716-881-6191",
            "fax_number": "716-881-6247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Goodell St",
            "address_2": "Suites 220 and 240",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031243",
            "country_code": "US",
            "telephone_number": "716-816-7228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Pine Ave",
            "address_purpose": "LOCATION",
            "city": "Niagara Falls",
            "state": "NY",
            "postal_code": "143012402",
            "country_code": "US",
            "telephone_number": "716-505-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALEIGH",
        "first_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "287526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04879503",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.