Individual provider Active NPI

Edward J Metzger Jr., MD

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1649245812
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F302895 Issued in NY
Practice address
40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F302895 NY Primary

Addresses

Primary practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344

Mailing address

640 Ellicott St
Suite 105
Buffalo, NY 14203-1245
Phone (716) 893-1010

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
I20060403000028 NY Practitioner - Nurse Practitioner 4082622428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Mobile Medical Care PCGroup PAC ID 8426575325, 97 clinicians

Practice addresses (Care Compare)

Buffalo, NY 14202
Phone (716) 893-1010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F302895NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Mobile Medical Care PC CurrentSince Apr 1, 2025 Accepting new patients
Mobile Primary Care Family Nurse Practitioners, PLLC PastSince Jun 1, 2007 Accepting new patients
Elder Medical Services PC PastSince Aug 1, 2004 Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients

Locations

40 La Riviere Dr
Ste 201A
Buffalo, NY 14202
Phone 7168931010221

Interoperability endpoints

  • Direct secure messaging: emetzger@mobileprimarycare.medentdirect.com

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 5

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1649245812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ELLICOTT ST",
            "address_2": "SUITE 105",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031245",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F302895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.