Active NPI
Jacek T Sosnowski, MD
- Urology Physician
- Amherst, NY
National Provider Identifier
1659362192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 058647
- Practice address
- 3580 Sheridan Dr
Suite 150
Amherst, NY 14226-1645 - Phone
- (716) 834-0100
- Fax
- (716) 834-1161
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 199804 | NY | |
| Urology Physician | 208800000X | 058647 | GA | Primary |
Addresses
Primary practice location
3580 Sheridan Dr
Suite 150
Amherst, NY 14226-1645
Mailing address
2805 N Oak St
Suite B
Valdosta, GA 31602
Phone (229) 316-2990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211307866A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270166400000",
"number": "1659362192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2805 N OAK ST",
"address_2": "SUITE B",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "31602",
"telephone_number": "229-316-2990",
"fax_number": "229-259-9547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 SHERIDAN DR",
"address_2": "SUITE 150",
"city": "AMHERST",
"state": "NY",
"postal_code": "142261645",
"telephone_number": "716-834-0100",
"fax_number": "716-834-1161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOSNOWSKI",
"first_name": "JACEK",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2010-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "199804",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "GA",
"license": "058647",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211307866A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amherst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.