Mark Peter Eberhard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

023400 Issued in NY

Practice address

3671 Southwestern Blvd Ste 101
Orchard Park, NY 14127-1749

Phone

(716) 662-7008

Fax

(716) 662-5226

NPI assigned

Apr 8, 2019

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 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Robert Erickson DO and Jennifer Erickson DO LLCGroup PAC ID 5991748626, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meberhard@familypractice.medentdirect.com

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.

• Robert Erickson DO and Jennifer Erickson DO LLC

  • Family Medicine Physician
  • Orchard Park, NY
  • NPI 1992866990
  Medicare reassignment Care Compare group
• Robert Erickson DO and Jennifer Erickson DO LLC

  • Health Educator
  • Orchard Park, NY
  • NPI 1386277366
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1760945877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD STE 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD STE 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARD",
        "first_name": "MARK",
        "middle_name": "PETER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "023400",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Dyson, M.D.
• Mary Joan Dziadaszek, OTR/L
• Teresa Eagan, PT
• East Amherst Physical Therapy, PC
• Nichol A Eaton-Wolkiewicz, PSYD
• Nancy Czyrny Ebling, DO
• Eckerd Corporation
• Ronald J Eckert, M.D.
• Jonathan S. Edelson, M.D.
• Aaron Edwards

• Physician Assistant in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.