Phoenix Rising Medical, PC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

183042 Issued in NY

Legal business name

PHOENIX RISING MEDICAL, PC

Practice address

2829 Wehrle Dr Ste 11a
Williamsville, NY 14221-7387

Phone

(716) 458-0069

Fax

(716) 458-0061

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tajuddin M Jiva, MDNPI 1598718983

Title

Owner

Phone

(716) 334-9879

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tajuddin Muhammad Jiva, MD MPH MBA

  • Pulmonary Disease Physician
  • Williamsville, NY
  • NPI 1598718983
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1649470790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 11A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "716-458-0069",
            "fax_number": "716-458-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 11A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "716-458-0069",
            "fax_number": "716-458-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "JIVA",
        "authorized_official_first_name": "TAJUDDIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-334-9879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "183042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber L Phillippi
• Curtis Phillippi, PA
• Andrea Elizabeth Phipps, PA
• James Lee Phipps Jr., D.C.
• Phoenix Healthcare, NP in Psychiatry, PLLC
• Physician Medical Services of Wny PC
• Jacqueline Piazza, PA-C
• John Daniel Picano, M.D.
• Deanna M Pieczynski, AGPCNP
• Meaghan Mary Piegay, PA-C

• Pulmonary Disease Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Pulmonary Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.