NPIMap

Organization Active NPI

Southtowns Gastroenterology, PLLC

  • Gastroenterology Physician
  • Orchard Park, NY
National Provider Identifier
1679872055
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
162503 Issued in NY
Legal business name
SOUTHTOWNS GASTROENTEROLOGY, PLLC
Practice address
3065 Southwestern Blvd
Ste 100
Orchard Park, NY 14127-1239
Phone
(716) 677-9220
Fax
(716) 677-9226
NPI assigned
Mar 24, 2011
Last updated
Mar 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Authorized official

Name
Albert Diaz-Ordaz, M.D.NPI 1588735203
Title
Physician
Phone
(716) 677-9220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 162503 NY Primary

Addresses

Primary practice location

3065 Southwestern Blvd
Ste 100
Orchard Park, NY 14127-1239

Mailing address

3065 Southwestern Blvd
Ste 100
Orchard Park, NY 14127-1239
Phone (716) 677-9220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000643 NY Part B Supplier - Clinic/Group Practice 8123204658 Receives reassigned benefits from 9 practitioners
Practice locations: Orchard Park, NY

National Provider Directory

National Provider Directory

Locations

3065 Southwestern Blvd
Ste 100
Orchard Park, NY 14127
Phone (716) 675-7443

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301270400000",
    "number": "1679872055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 SOUTHWESTERN BLVD",
            "address_2": "STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271239",
            "telephone_number": "716-677-9220",
            "fax_number": "716-677-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 SOUTHWESTERN BLVD",
            "address_2": "STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271239",
            "telephone_number": "716-677-9220",
            "fax_number": "716-677-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHTOWNS GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-28",
        "status": "A",
        "authorized_official_last_name": "DIAZ-ORDAZ",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "716-677-9220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "162503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.