NPIMap

Organization Active NPI

Mindful Connections Psychiatry PLLC

  • Psychiatry Physician
  • Williamsville, NY
National Provider Identifier
1801674106
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MINDFUL CONNECTIONS PSYCHIATRY PLLC
Practice address
8203 Main St Ste 2
Williamsville, NY 14221-6051
Phone
(716) 219-3636
Fax
(716) 209-3680
NPI assigned
Sep 18, 2023
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Dr. Biswarup Manojkumar Ghosh
Title
Owner
Phone
(716) 219-3636

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU Primary
Medical Physician Assistant 363AM0700X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

8203 Main St Ste 2
Williamsville, NY 14221-6051

Mailing address

2372 Sweet Home Rd Ste 3
Amherst, NY 14228-2330
Phone (716) 389-3267

Other practice location 1

1263 Delaware Ave
Buffalo, NY 14209-2402
Phone (716) 219-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231113001997 NY Part B Supplier - Clinic/Group Practice 4385091347 Receives reassigned benefits from 10 practitioners
Practice locations: Buffalo, NY; Williamsville, NY

National Provider Directory

National Provider Directory

Locations

8203 Main St
Ste 2
Williamsville, NY 14221
Phone (716) 219-3636

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1801674106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 SWEET HOME RD STE 3",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282330",
            "telephone_number": "716-389-3267",
            "fax_number": "716-639-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8203 MAIN ST STE 2",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216051",
            "telephone_number": "716-219-3636",
            "fax_number": "716-209-3680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1263 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142092402",
            "country_code": "US",
            "telephone_number": "716-219-3636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL CONNECTIONS PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "GHOSH",
        "authorized_official_first_name": "BISWARUP MANOJKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-219-3636",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.