NPIMap

Individual provider Active NPI

Jennifer Ann Wisnoski, M.D.

  • Family Medicine Physician
  • Williamsville, NY
National Provider Identifier
1790740637
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
230380 Issued in NY
Practice address
295 Essjay Rd
Williamsville, NY 14221-8216
Phone
(716) 565-1234
Fax
(716) 556-1246
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 230380 NY Primary

Addresses

Primary practice location

295 Essjay Rd
Williamsville, NY 14221-8216

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000590 NY Practitioner - Family Practice 5698794089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 630-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2015 Accepting new patients
Buffalo Medical Group, P.C. Family Medicine CurrentSince Sep 1, 2015 Accepting new patients
Northtowns Imaging PC PastSince Nov 1, 2005 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

295 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1050

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • Direct secure messaging: jwisnoski6254@direct.buffalomedicalgroup.com
  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1790740637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 ESSJAY RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218216",
            "telephone_number": "716-565-1234",
            "fax_number": "716-556-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNOSKI",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "230380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "295 Essjay Rd",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142218216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.