Individual provider Active NPI

Antonia Redhead, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1740224641
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
222423 Issued in NY
Practice address
1461 Kensington Ave
Buffalo, NY 14215
Phone
(716) 831-8612
Fax
(716) 831-8649
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 222423 NY Primary

Addresses

Primary practice location

1461 Kensington Ave
Buffalo, NY 14215

Mailing address

462 Grider St
BLDG CC Room 151
Buffalo, NY 14215
Phone (716) 898-6206

Other identifiers 1

IdentifierTypeStateIssuer
02187011MedicaidNY

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
I20050516000093 NY Practitioner - Family Practice 5092756593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222423NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Emergency Medical Services Inc. Current Accepting new patients
Erie County Medical Center Corporation CurrentSince Nov 24, 2011 Accepting new patients
Ub Family Medicine, Inc Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Erie County Medical Center Corporation CurrentSince Nov 24, 2011 Accepting new patients
Exigence Hospitalist Medical Services of Hornell, PLLC Past Accepting new patients
Exigence Hospitalist Medical Services of Olean, PLLC Past Accepting new patients
Erie County Medical Center Corporation Past Accepting new patients
Niagara Hospitalist, PC Past Accepting new patients
Keystone Hospitalist Services of New York P.C. Past Accepting new patients

Locations

462 Grider St
Bldg Cc
Buffalo, NY 14215

1461 Kensington Ave
Buffalo, NY 14215
Phone (716) 831-8612

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

4000 Bailey Ave
Eggertsville, NY 14226
Phone (716) 446-1041

521 East Ave
Lockport, NY 14094
Phone (716) 434-9111

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Interoperability endpoints

  • Direct secure messaging: antoniaredhead@ecmcny.allscriptsdirect.net

Organizations & group practices 9

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 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740224641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "address_2": "BLDG CC ROOM 151",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-898-6206",
            "fax_number": "716-898-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 KENSINGTON AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-831-8612",
            "fax_number": "716-831-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDHEAD",
        "first_name": "ANTONIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "222423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.