Individual provider Active NPI

Conrad McMahon

  • Emergency Medicine Physician
  • Buffalo, NY
National Provider Identifier
1679062590
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
310336-01 Issued in NY
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-1993
NPI assigned
May 7, 2018
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14202-0000 NY
Emergency Medicine Physician 207P00000X 310336-01 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

304 N McBride St Apt 2
Syracuse, NY 13203-2364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210604000516 NY Practitioner - Emergency Medicine 4486991056 Reassigns benefits to 2 organizations
I20260520000153 NJ Practitioner - Emergency Medicine 4486991056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nyack Emergency Medical Association PLLCGroup PAC ID 2062411036, 59 clinicians
Stadium Emergency AssociatesGroup PAC ID 6406150010, 24 clinicians

Practice addresses (Care Compare)

160 N Midland Ave
Nyack, NY 10960-1912
Phone (954) 939-5000

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
14202-0000NYMDEmergency Medicine Physician
310336-01NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Associates New York PC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Nyack Emergency Medical Association PLLC Single Specialty CurrentSince Oct 7, 2023 Accepting new patients
Physicians Medical Associates New York PC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Interoperability endpoints

  • Direct secure messaging: cmcmahon2387785@direct.trinity-health.org

Organizations & group practices 4

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 2

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1679062590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N MCBRIDE ST APT 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "CONRAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "14202-0000",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "310336-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.