Pediatric Healthcare

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

237701 Issued in NY

Legal business name

PEDIATRIC HEALTHCARE

Practice address

4039 Rte 219 Suite 103
Salamanca, NY 14779-9625

Phone

(716) 945-0368

Fax

(716) 945-0757

NPI assigned

May 3, 2007

Last updated

Jul 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Srinivas P Thandla, M.D.NPI 1043351091

Title

Sole Proprietor

Phone

(716) 945-0368

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srinivas Thandla, MD

  • Pediatrics Physician
  • Salamanca, NY
  • NPI 1043351091
  NPD (past) Authorized official
• Megan K Crosson, NP

  • Pediatric Clinical Nurse Specialist
  • Salamanca, NY
  • NPI 1679753990
  NPD (past)
• Emily M Karn, PA

  • Medical Physician Assistant
  • Salamanca, NY
  • NPI 1730465618
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1679795025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 RTE 219 SUITE 103",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147799625",
            "telephone_number": "716-945-0368",
            "fax_number": "716-945-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 RTE 219 SUITE 103",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147799625",
            "telephone_number": "716-945-0368",
            "fax_number": "716-945-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "THANDLA",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "716-945-0368",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "237701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02056637",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olean Medical Group Partnership
• Olean Medical Practice PLLC (Olean Medical Group)
• Angie Olson, LMSW
• Evelyn Ouellette, CRNP
• Arun P Patel, MD
• Peter C Perez, DDS
• Jordan Perry, MD
• Victoria Florence Petherick, LCSW
• Sarah Pinchoff, MSW
• J Nicholas Porcello, DDS

• Pediatrics Physician in Salamanca, NY
• Providers in Salamanca, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.