Albert J Addesa Jr., MD
Individual provider Active NPI Family Medicine Physician · Lancaster, NY
NPI 1609804368 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609804368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 144992 (NY)
- Practice address
- 5532 Broadway St
Lancaster, NY 14086-2224 - Phone
- (716) 683-5252
- Fax
- (716) 683-6885
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Associated Physicians of Western New York PC
Practice addresses (Care Compare)
1616 Kensington Ave
Buffalo, NY 14215-1433
Phone (716) 835-3097
Hospital & facility affiliations
- Sisters of Charity Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111209000413 | NY | Practitioner - Family Practice | 0244405843 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Physicians of Western New York P.C. | Family Medicine | Current |
Accepting new patients |
Locations
1616 Kensington Ave
Buffalo, NY 14215
Phone (716) 834-3278
2805 Wehrle Dr
Ste 10
Williamsville, NY 14221
Phone (716) 631-1622
Interoperability endpoints
- draddesa@apwny.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 144992 | NY | Yes |
Addresses
Primary practice location
5532 Broadway St
Lancaster, NY 14086-2224
Mailing address
1616 Kensington Ave
Buffalo, NY 14215-1433
Phone (716) 835-3097
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00725315 | Medicaid | NY |
Other providers in Lancaster, NY
- 1818 Como Park Boulevard Operating Company LLC
- Hope Ackerly
- Krista Marie Anastasi
- Monie Applegate
- Judith Cecilia Arnold
- Around the Town Taxi Service
- Tonya Aust
All providers in Lancaster, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.