Andrea M Buccilli, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2517621 Issued in NY

Practice address

70 Professional Pkwy
Lockport, NY 14094-5366

Phone

(716) 434-7505

Fax

(716) 439-9084

NPI assigned

Mar 23, 2009

Last updated

Oct 18, 2010By the provider in NPPES

Sex

Female

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles J Fetterman MD PCGroup PAC ID 8527038652, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount St. Mary's Hospital & Health Center Hospital, Lewiston, NY, CCN 330188

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abuccilli@fetterman.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles J Fetterman MD PC

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1316004013
  Medicare reassignment Care Compare group NPD

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

• Mount St. Mary's Hospital of Niagara Falls

  dba Mount St. Mary's Hospital and Health Center

  • General Acute Care Hospital
  • Lewiston, NY
  • NPI 1043394745
  Care Compare affiliation

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1770724635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PKWY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PKWY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCILLI",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "2517621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03118054",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Lynn Brink
• Briody Health Care Faciltiy LLC
• James Earl Brooks
• Sherwin W Brownsten, OPTICIAN
• Stephanie M Bruzgul, P.A.
• Nancy Kathleen Budzinski, PT
• Buffalo Hearing and Speech Center
• Buffalo Medical Group, P.C.
• Buffalo Medical Group, PC
• Buffalo Spine Surgery, PLLC

• Ophthalmology Physician in Lockport, NY
• Providers in Lockport, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.