Individual provider Active NPI

Ju Hoan Joh, M.D. M.S. M.P.H

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1750737110
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
292170 Issued in NY
Practice address
511 Farber Lakes Dr
Buffalo, NY 14221-5779
Phone
(716) 815-3344
Fax
(716) 242-0171
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 292170 NY Primary

Addresses

Primary practice location

511 Farber Lakes Dr
Buffalo, NY 14221-5779

Mailing address

40 La Riviere Dr Ste 140
Buffalo, NY 14202-4306
Phone (716) 893-1010

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
I20181203002470 NY Practitioner - General Practice 2062756018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mikram Jafri MD PCGroup PAC ID 1052783396, 6 clinicians

Practice addresses (Care Compare)

81 Park St
Elizabethtown, NY 12932-2300
Phone (518) 873-3570

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292170NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2021 Accepting new patients
Mikram Jafri MD PC CurrentSince Dec 1, 2023 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2021 Accepting new patients
Concerto Care Medical Group of New York, PC CurrentSince Dec 9, 2024 Accepting new patients
185 Old Military Road Operating Company, LLC Past Accepting new patients

Locations

50 Fountain Plz
Ste 1400
Buffalo, NY 14202
Phone (718) 504-9256

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

185 Old Military Rd
Lake Placid, NY 12946
Phone (518) 523-2464

100 New Turnpike Rd
Troy, NY 12182
Phone (518) 235-1410

338 Harris Hill Rd
Ste 207
Williamsville, NY 14221

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1750737110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 140",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024306",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 FARBER LAKES DR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142215779",
            "telephone_number": "716-815-3344",
            "fax_number": "716-242-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOH",
        "first_name": "JU",
        "middle_name": "HOAN",
        "name_prefix": "Dr.",
        "credential": "M.D. M.S. M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "292170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.