Glenn Robert Buczkowski, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

006921 Issued in NY

Practice address

4927 Main St
Ste 400
Amherst, NY 14226-4081

Phone

(716) 877-7000

Fax

(716) 322-1164

NPI assigned

Jun 30, 2006

Last updated

Dec 22, 2021By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael a Vasquez MD PCGroup PAC ID 2365471356, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbuczkowski@venousinstitute.medentdirect.com

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.

• Michael a Vasquez, MD, PC

  • Vascular Surgery Physician
  • Amherst, NY
  • NPI 1588749816
  Medicare reassignment Care Compare group
• Mivas, P.C.

  • Acute Care Nurse Practitioner
  • Amherst, NY
  • NPI 1265143630
  NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1639107196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 MAIN ST",
            "address_2": "STE 400",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264081",
            "telephone_number": "716-690-2691",
            "fax_number": "716-690-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 MAIN ST",
            "address_2": "STE 400",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264081",
            "telephone_number": "716-877-7000",
            "fax_number": "716-322-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZKOWSKI",
        "first_name": "GLENN",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006921",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "006921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara S Brownschidle, M.D.
• Madison Brunke, PT
• Karen Bruno, MRI TECHNOLOGIST
• Lisa Brzeczkowski, MA, CCC-SLP, LICENSE
• Richard Joseph Buckley Jr., MD
• James L Budny, M.D.
• Buffalo Amherst Allergy Associates P.C.
• Buffalo Athletic Club Suburban, Inc.
• Buffalo Beacon Corporation (Beacon Center)
• Buffalo Bodywork LLC

• Surgical Physician Assistant in Amherst, NY
• Providers in Amherst, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.