Individual provider Active NPI

Talal Roshan, M.D.

  • Family Medicine Physician
  • Williamsville, NY
National Provider Identifier
1699358549
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0073888 Issued in CO
Practice address
111 N Maplemere Rd Ste 150
Williamsville, NY 14221-3181
Phone
(716) 899-4772
NPI assigned
Apr 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0073888 CO Primary

Addresses

Primary practice location

111 N Maplemere Rd Ste 150
Williamsville, NY 14221-3181

Mailing address

PO Box 488
Buffalo, NY 14240-0488
Phone (716) 852-4772

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
I20241220000592 NY Practitioner - Family Practice 1759818354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

111 N Maplemere Rd
Suite 200
Williamsville, NY 14221-3182
Phone (716) 204-4532

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0073888COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Oct 14, 2024 Accepting new patients
General Physician, PC PastSince Nov 17, 2024 Accepting new patients

Locations

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

111 N Maplemere Rd
Ste 200
Williamsville, NY 14221
Phone (716) 626-2644

111 N Maplemere Rd
Ste 150
Williamsville, NY 14221
Phone (716) 626-2644

Interoperability endpoints

  • Direct secure messaging: troshan@gppc.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1699358549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "716-852-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 150",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213181",
            "telephone_number": "716-899-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHAN",
        "first_name": "TALAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0073888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.