Upstate Dermatopathology PLLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

UPSTATE DERMATOPATHOLOGY PLLC

Practice address

6400 Sheridan Dr Ste 224
Williamsville, NY 14221-4842

Phone

(716) 334-0357

NPI assigned

Oct 16, 2023

Last updated

Oct 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Liaqat Ali, MDNPI 1053547885

Title

Medical Director/Owner

Phone

(716) 574-6513

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liaqat Ali, M.D.

  • Dermatopathology Physician
  • Monroe, MI
  • NPI 1053547885

  NY

  Medicare reassignment NPD Authorized official
• Hong Jiang, MD

  • Dermatopathology (Pathology) Physician
  • Middletown, NY
  • NPI 1912068420
  NPD

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1790567774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHERIDAN DR STE 224",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214842",
            "telephone_number": "716-334-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SHERIDAN DR STE 224",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214842",
            "telephone_number": "716-334-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE DERMATOPATHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "LIAQAT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "716-574-6513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kylie Urbanczyk, LPN
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• Megan Nicole Urbank, PA-C

• Dermatopathology Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Dermatopathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.