Individual provider Active NPI

Marcelino Fabian D'Souza, MD

  • Obstetrics & Gynecology Physician
  • East Amherst, NY
National Provider Identifier
1790899458
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
145872 Issued in NY
Practice address
8750 Transit Rd
Suite 205
East Amherst, NY 14051-2610
Phone
(716) 639-7970
Fax
(716) 639-7968
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 145872 NY Primary

Addresses

Primary practice location

8750 Transit Rd
Suite 205
East Amherst, NY 14051-2610

Mailing address

908 Niagara Falls Blvd Ste 208
North Tonawanda, NY 14120-2019
Phone (716) 692-3302

Other identifiers 1

IdentifierTypeStateIssuer
00753975MedicaidNY

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
I20111004000239 NY Practitioner - Obstetrics/Gynecology 8729250345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145872NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Dec 4, 2017 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Mar 17, 2018 Accepting new patients
Kaleida Health CurrentSince Mar 17, 2018 Accepting new patients
Cny Fertility Center Past Accepting new patients

Locations

899 Main St
Buffalo, NY 14203
Phone (716) 862-6544

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

705 Maple Rd
Williamsville, NY 14221
Phone (716) 580-7300

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Organizations & group practices 5

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1790899458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD STE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 TRANSIT RD",
            "address_2": "SUITE 205",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512610",
            "telephone_number": "716-639-7970",
            "fax_number": "716-639-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'SOUZA",
        "first_name": "MARCELINO",
        "middle_name": "FABIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "145872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753975",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.