Individual provider Active NPI

Brian L. Caldwell, EDD, RN, AGPCNP-BC

  • Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1639529035
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
307736 Issued in NY
Practice address
Elm and Carton St
Buffalo, NY 14263
Phone
(716) 845-2300
NPI assigned
Jun 16, 2016
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 307736 NY Primary
Adult Health Nurse Practitioner 363LA2200X 307736 NY

Addresses

Primary practice location

Elm and Carton St
Buffalo, NY 14263

Mailing address

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other identifiers 1

IdentifierTypeStateIssuer
30 307736MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611000155 NY Practitioner - Nurse Practitioner 8426330895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
307736NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Church Home of the Protestant Episcopal Church in the City of Roch Current Accepting new patients
Jamestown Area Medical Associates, L.L.P. Adult Health CurrentSince Jun 1, 1997 Accepting new patients
Roswell Park Cancer Institute CurrentSince May 1, 2023 Accepting new patients
Great Lakes Physician Practice PC CurrentSince Jul 1, 2022 Accepting new patients
Roswell Park Cancer Institute CurrentSince May 1, 2023 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: briancaldwell@eslc.netsmartdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1639529035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14263",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "BRIAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "EDD, RN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "307736",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307736",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30 307736",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 56",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.