Individual provider Active NPI

Dominic Pietro Stutz, PA

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1689306250
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028452 Issued in NY
Practice address
4949 Harlem Rd
Amherst, NY 14226-2500
Phone
(716) 204-3200
NPI assigned
Jun 30, 2022
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028452 NY Primary

Addresses

Primary practice location

4949 Harlem Rd
Amherst, NY 14226-2500

Mailing address

4225 Genesee St Ste 400
Cheektowaga, NY 14225-1994
Phone (716) 204-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220802003178 NY Practitioner - Physician Assistant 7719369057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as group
Quality
77.6
Promoting interoperability
100
Improvement activities
40
Cost
81.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Services Inc. CurrentSince Jul 5, 2022 Accepting new patients

Locations

160 Farber Hall
Buffalo, NY 14214
Phone (716) 829-2070

4949 Harlem Rd
Buffalo, NY 14226
Phone (716) 204-3201

Organizations & group practices 2

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": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1689306250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GENESEE ST STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251994",
            "telephone_number": "716-204-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 HARLEM RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262500",
            "telephone_number": "716-204-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZ",
        "first_name": "DOMINIC",
        "middle_name": "PIETRO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.