Colin Tedesco, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

3900 N Buffalo St
Orchard Park, NY 14127-1842

Phone

(716) 630-1151

Fax

(716) 250-5997

NPI assigned

Mar 16, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colin.tedesco@nfmmc.eclinicaldirectplus.com

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.

• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Medicare reassignment
• Trinity Medical Wny PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1295043149
  Medicare reassignment
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  NPD
• Sisters of Charity Hospital of Buffalo New York

  • Obstetrics & Gynecology Physician
  • Buffalo, NY
  • NPI 1568090660
  NPD
• Trinity Medical Wny PC

  • Orthopaedic Surgery Physician
  • Williamsville, NY
  • NPI 1144878893

  Physician Assistant

  NPD
• Trinity Medical Wny PC

  • Vascular Surgery Physician
  • Buffalo, NY
  • NPI 1205468055
  NPD

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1558722611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271842",
            "telephone_number": "716-630-1151",
            "fax_number": "716-250-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "COLIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "3900 N Buffalo St",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jamie Lee Tarnacki
• Lauren Marie Taylor
• Holly Marie Tedesco, CCC-SLP, NYS LIC
• Telehealth Medical Services of Ny PC
• The Dental Group P.C.
• Therapeutic Link for Children
• Therapeutic Link for Children, PLLC

• Medical Physician Assistant in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.