Individual provider Active NPI

Britton Edgett Tisdale, M.D., B.SC.PHM.

  • Urology Physician
  • Amherst, NY
National Provider Identifier
1679888606
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
271542 Issued in NY
Practice address
36 Nature Cove CT
Amherst, NY 14221-1978
Phone
(716) 319-8113
NPI assigned
Aug 14, 2010
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0116021688 VA
Urology Physician 208800000X 003851 NY
Urology Physician 208800000X 271542 NY Primary

Addresses

Primary practice location

36 Nature Cove CT
Amherst, NY 14221-1978

Mailing address

180 Vine Street South
Suite 202
St. Catharines, ONTARIO L2R 7P3
CA

Other identifiers 5

IdentifierTypeStateIssuer
533379001OtherNYBLUE CROSS
652569OtherNYWELLCARE
1916947OtherNYIHA
29695201OtherNYUNIVERA
3383479MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110919000115 NY Practitioner - Urology 7517138829 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003851NYMDUrology Physician
0116021688VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Feb 12, 2012 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Feb 12, 2012 Accepting new patients
Academic Medicine Services, Inc. Past Accepting new patients

Locations

100 High St
Ste C3
Buffalo, NY 14203
Phone (716) 859-5608

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

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

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": "1281744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1679888606",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "180 VINE STREET SOUTH",
            "address_2": "SUITE 202",
            "city": "ST. CATHARINES",
            "state": "ONTARIO",
            "postal_code": "L2R 7P3"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 NATURE COVE CT",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142211978",
            "telephone_number": "716-319-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "BRITTON",
        "middle_name": "EDGETT",
        "name_prefix": "Dr.",
        "credential": "M.D., B.SC.PHM.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-14",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0116021688",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "003851",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "271542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "533379001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "652569",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1916947",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "29695201",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3383479",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.