Individual provider Active NPI

Mark Stephen St Marie, MD

  • Gastroenterology Physician
  • Williamsville, NY
National Provider Identifier
1629150792
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
136312 Issued in NY
Practice address
111 N Maplemere Rd Ste 200
Williamsville, NY 14221-3182
Phone
(716) 626-2644
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 136312 NY Primary

Addresses

Primary practice location

111 N Maplemere Rd Ste 200
Williamsville, NY 14221-3182

Mailing address

111 N Maplemere Rd Ste 200
Williamsville, NY 14221-3182
Phone (716) 626-2644

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
I20120223000556 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 2567448822 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

111 N Maplemere Rd
Suite 200
Williamsville, NY 14221-3182
Phone (716) 204-4532

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Oct 8, 2012 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Oct 8, 2012 Accepting new patients
General Physician, PC CurrentSince Sep 9, 2024 Accepting new patients
Buffalo Gastroenterology Associates, LLP Specialist Current Accepting new patients

Locations

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

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

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

888 Center Rd
West Seneca, NY 14224
Phone (716) 675-3530

111 N Maplemere Rd
Ste 200
Williamsville, NY 14221
Phone (716) 626-2644

Interoperability endpoints

  • Direct secure messaging: mstmarie@gppc.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1629150792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213182",
            "telephone_number": "716-626-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213182",
            "telephone_number": "716-626-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST MARIE",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "136312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.