Jerald Robert Sultz, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

181975 Issued in NY

Practice address

1301 N Forest Rd
Suite 1
Williamsville, NY 14221-3277

Phone

(716) 634-1970

Fax

(716) 634-3845

NPI assigned

Nov 30, 2006

Last updated

Jun 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Specialty

Plastic and Reconstructive Surgery

Education

State University of Ny Upstate Medical University, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western New York Dermatology PLLCGroup PAC ID 6103141619, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

96.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Western New York Dermatology, PLLC

  • Specialist
  • Williamsville, NY
  • NPI 1083030498
  Medicare reassignment Care Compare group NPD
• Frank R. Laurri, M.D. & Associates, P.C.

  • Internal Medicine Physician
  • Niagara Falls, NY
  • NPI 1548305519
  Medicare reassignment NPD
• Frank R. Laurri, M.D. & Associates, P.C.

  • Registered Nurse
  • Niagara Falls, NY
  • NPI 1902563646
  NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1699842781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N FOREST RD",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213277",
            "telephone_number": "716-634-1970",
            "fax_number": "716-634-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N FOREST RD",
            "address_2": "SUITE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213277",
            "telephone_number": "716-634-1970",
            "fax_number": "716-634-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTZ",
        "first_name": "JERALD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "181975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "CPS181975-4B",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFER",
            "identifier": "16-1605603",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPEDENT HEALTH",
            "identifier": "1309949",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED EMPIRE",
            "identifier": "1320353",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BLUE SHIELD",
            "identifier": "000524867",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010309402",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000524867002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE",
            "identifier": "50599",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David William Suchyna, PT, DPT
• Yelena Suffoletto, RN
• Dina Sulaiman, M.D.
• Nancy L Sullivan, NP
• Susan M Sullivan, L.M.T.
• Thomas Summers, MD
• Katherine Sumner, R-PAC
• Janet Sung, MD
• Superior Billing LLC
• Suren Mewar,D.D.S.,P.C., and Amy Richter, D.M.D., P.C., PLLC

• Plastic Surgery Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.