Roswell Park Cancer Institute
Organization Active NPI Multi-Specialty Clinic/Center · Buffalo, NY
NPI 1720036593 · NPPES record last updated Jun 15, 2015
Key facts
- NPI
- 1720036593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- ROSWELL PARK CANCER INSTITUTE
- Practice address
- Elm and Carlton St
Buffalo, NY 14263-0001 - Phone
- (716) 845-2300
- NPI assigned
- May 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Candace S Johnson, PHD
- Title
- President & Ceo
- Phone
- (716) 845-2300
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Practitioners 707
-
Sara Abou Azar, M.D.
-
Mohei E Abouzied, MD
-
Runa Acharya, MD
-
Kelsey Lee Adamson, M.D.
-
Tina Agostinelli, PA
-
Joanna Aiken, DO
-
William Brent Alexander Jr., MD, PHD
-
Sahar Amin, MD
-
Molly B Aungst, ANP
-
Matthew J Barth, MD
-
Michael John Bax, MD
-
Stephanie Baxter, DNP
-
Alexander Becker, MD
-
Shelby Milan Belair, AGNP-BC
-
Romel Adupe Bertulfo, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Roswell Park Cancer Institute |
Hospital | Operational/Managerial Control | Jan 1, 1999 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000466 | NY | Part B Supplier - Clinic/Group Practice | 3577475110 |
Receives reassigned benefits from 702 practitioners Practice locations: Ithaca, NY; Williamsville, NY; Olean, NY; Niagara Falls, NY; Lewiston, NY; Cheektowaga, NY; Buffalo, NY; Amherst, NY |
National Provider Directory
Locations
26691 Plaza
Mission Viejo, CA 92691
Phone (949) 364-9054
Dept 8000
Buffalo, NY 14267
100 College Pkwy
Williamsville, NY 14221
Phone (716) 636-1902
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
Elm and Carlton St
Buffalo, NY 14263-0001
Mailing address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02997079 | Medicaid | NY |
Other providers in Buffalo, NY
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Cancer Institute
- Roswell Park Pharmacy Corporation
- Laurie A D Roth
- Marcia Ann Roth
All providers in Buffalo, NY · Multi-Specialty Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.