Theodore Inman Putnam, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

095973 Issued in NY

Practice address

219 Bryant St
Buffalo, NY 14222-2006

Phone

(716) 878-7109

Fax

(716) 888-3874

NPI assigned

Apr 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1427007046
  NPD (past)
• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1760447288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 HARLEM ROAD",
            "address_2": "SUITE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263822",
            "telephone_number": "716-839-6720",
            "fax_number": "716-839-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 BRYANT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142222006",
            "telephone_number": "716-878-7109",
            "fax_number": "716-888-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTNAM",
        "first_name": "THEODORE",
        "middle_name": "INMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "095973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010142001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426002230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014382740001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000503501002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00639423",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "051028000061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "061102000045",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1211171",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000503501004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000503501005",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Barbara Purcell, FNP
• Pure Podiatry of Wny PLLC
• Sumangala P Puri, M.D.
• Christopher Roy Pusateri, D.D.S.
• Cheryl Ann Putnam, MD
• Andrew Putzak
• Jenniffer M Puyarena
• Igor Puzanov, MD
• James L Pygon Jr., R.N.
• Stacey E Pynn, PA

• Pediatrics Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.