Individual provider Active NPI

Mary Catherine Kauderer, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Williamsville, NY
National Provider Identifier
1720212277
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
250805-1 Issued in NY
Practice address
325 Essjay Rd
Williamsville, NY 14221-8243
Phone
(716) 630-1290
Fax
(716) 250-5994
NPI assigned
May 13, 2009
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 250805-1 NY Primary

Addresses

Primary practice location

325 Essjay Rd
Williamsville, NY 14221-8243

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

3900 N. Buffalo Road
Orchard Park, NY 14127
Phone (716) 630-1290

Other names 1

  • Dr. Mary Catherine Berowski Former name

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
I20101021000070 NY Practitioner - Physical Medicine and Rehabilitation 0840483996 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250805-1NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Jun 1, 2016 Accepting new patients
Kaleida Health Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2010 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2010 Accepting new patients
Kaleida Health CurrentSince Jun 1, 2016 Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

1170 Main St
Buffalo, NY 14209
Phone (716) 882-1025

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

295 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1050

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

425 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1219

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

Organizations & group practices 5

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1720212277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218243",
            "telephone_number": "716-630-1290",
            "fax_number": "716-250-5994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 N. Buffalo Road",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "14127",
            "country_code": "US",
            "telephone_number": "716-630-1290",
            "fax_number": "716-250-5994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUDERER",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "250805-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BEROWSKI",
            "middle_name": "CATHERINE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.