Individual provider Active NPI

Jerome J Ulatowski II, MD

  • Pediatrics Physician
  • Niagara Falls, NY
National Provider Identifier
1790783355
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
159192 Issued in NY
Practice address
6937 Williams Rd
Niagara Falls, NY 14304-3022
Phone
(716) 298-1107
Fax
(716) 298-5737
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 159192 NY Primary
Occupational Medicine Physician 2083X0100X 159192 NY

Addresses

Primary practice location

6937 Williams Rd
Niagara Falls, NY 14304-3022

Mailing address

6937 Williams Rd
Niagara Falls, NY 14304-3022
Phone (716) 298-1107

Other identifiers 1

IdentifierTypeStateIssuer
1167817MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091119000267 NY Practitioner - Pediatric MedicinePractitioner - Internal MedicinePractitioner - Preventive Medicine 6103964770 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159192NYMDParamedic

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Trinity Medical Wny PC CurrentSince Jan 1, 2021 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Nov 15, 2012 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Nov 15, 2012 Accepting new patients
Trinity Medical Wny PC CurrentSince Jan 1, 2021 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Nysarc, Inc. Cattaraugus-Niagara County Chapter Past Accepting new patients
Summit Pediatrics, P.C. Pediatrics Past Accepting new patients
Nysarc, Inc. Cattaraugus-Niagara County Chapter Past Accepting new patients

Locations

4988 Harlem Rd
Amherst, NY 14226
Phone (716) 564-2273

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

5014 Transit Rd
Depew, NY 14043
Phone (716) 684-2273

6375 Transit Rd
#2000
Depew, NY 14043
Phone (716) 684-2273

2950 Elmwood Ave
Ste A1
Kenmore, NY 14217
Phone (716) 529-3070

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1790783355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6937 WILLIAMS RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143043022",
            "telephone_number": "716-298-1107",
            "fax_number": "716-298-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6937 WILLIAMS RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143043022",
            "telephone_number": "716-298-1107",
            "fax_number": "716-298-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULATOWSKI",
        "first_name": "JEROME",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "159192",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "159192",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1167817",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.