NPIMap

Organization Active NPI

Buffalo Spine & Sports Medicine PC

  • Physical Medicine & Rehabilitation Physician
  • Williamsville, NY
National Provider Identifier
1770517765
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1622591 Issued in NY
Legal business name
BUFFALO SPINE & SPORTS MEDICINE PC
Practice address
100 College Parkway
Suite 100
Williamsville, NY 14221
Phone
(716) 626-0093
Fax
(716) 626-9193
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Mr. Sheri Zillioux
Title
Executive Director
Phone
(716) 650-3115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 1622591 NY Primary

Addresses

Primary practice location

100 College Parkway
Suite 100
Williamsville, NY 14221

Mailing address

100 College Parkway
Suite 100
Williamsville, NY 14221
Phone (716) 626-0093

Other identifiers 1

IdentifierTypeStateIssuer
02396821MedicaidNY

Other names 1

  • Buffalo Spine & Sports Institute Doing business as

National Provider Directory

National Provider Directory

Locations

4949 Harlem Rd
Ste 300
Amherst, NY 14226
Phone (716) 204-3263

6133 Route 219 S
Ste 1003
Ellicottville, NY 14731

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1770517765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-626-0093",
            "fax_number": "716-626-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PARKWAY",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-626-0093",
            "fax_number": "716-626-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO SPINE & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "ZILLIOUX",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-650-3115",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "1622591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02396821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buffalo Spine & Sports Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.