NPIMap

Individual provider Active NPI

Peter Louis Gambacorta, D.O.

  • Specialist
  • East Amherst, NY
National Provider Identifier
1700089596
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
256227 Issued in NY
Practice address
8750 Transit Rd
Suite 105
East Amherst, NY 14051-2610
Phone
(716) 636-1470
Fax
(716) 636-1423
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 256227 NY Primary

Addresses

Primary practice location

8750 Transit Rd
Suite 105
East Amherst, NY 14051-2610

Mailing address

3925 Sheridan Dr
Ste 100
Amherst, NY 14226-1738
Phone (716) 250-6492

Other identifiers 2

IdentifierTypeStateIssuer
1700089596OtherNYNPI
256227OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110310000410 NY Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 9537255831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
89.94
Promoting interoperability
88
Improvement activities
40
Cost
82.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement37
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256227NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Oct 1, 2019 Accepting new patients
Excelsior Orthopaedics LLP Specialist CurrentSince Oct 1, 2019 Accepting new patients
Kaleida Health CurrentSince Oct 17, 2010 Accepting new patients
Kaleida Health CurrentSince Oct 17, 2010 Accepting new patients
Kaleida Health Current Accepting new patients
Bes of Ohio, LLC, Dba Medgroup Past Accepting new patients
Bes of Ohio, LLC Past Accepting new patients

Locations

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

100 High St
#13282
Buffalo, NY 14203

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

3925 Sheridan Dr
Ste 100
Buffalo, NY 14226
Phone (716) 250-6492

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

Interoperability endpoints

  • Direct secure messaging: pgambacorta@excelsiorortho.medentdirect.com

Organizations & group practices 7

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 7

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1700089596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "address_2": "STE 100",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-6492",
            "fax_number": "716-250-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 TRANSIT RD",
            "address_2": "SUITE 105",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512610",
            "telephone_number": "716-636-1470",
            "fax_number": "716-636-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBACORTA",
        "first_name": "PETER",
        "middle_name": "LOUIS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "256227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700089596",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "256227",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.