Individual provider Active NPI

John Anthony Paolini, PA, MS, ATC, CSCS

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1679618284
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019050 Issued in NY
Practice address
4949 Harlem Rd
University Orthopaedic Services, Inc
Amherst, NY 14226-2500
Phone
(716) 204-3251
NPI assigned
Feb 21, 2007
Last updated
Sep 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003671 PA
Physician Assistant 363A00000X 019050 NY Primary

Addresses

Primary practice location

4949 Harlem Rd
University Orthopaedic Services, Inc
Amherst, NY 14226-2500

Mailing address

5500 Main St
Suite 107
Williamsville, NY 14221-6755
Phone (716) 906-5908

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
I20151119001020 NY Practitioner - Physician Assistant 2466752654 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
RT003671PAMDAthletic Trainer
019050NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Oct 15, 2016 Accepting new patients
Kaleida Health CurrentSince Oct 15, 2016 Accepting new patients

Locations

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Interoperability endpoints

  • Direct secure messaging: jpaolini@ubortho.medentdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1679618284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST",
            "address_2": "SUITE 107",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216755",
            "telephone_number": "716-906-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 HARLEM RD",
            "address_2": "UNIVERSITY ORTHOPAEDIC SERVICES, INC",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262500",
            "telephone_number": "716-204-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLINI",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Prof.",
        "credential": "PA, MS, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003671",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.