Individual provider Active NPI

Johanna Christine Innes, M.D.

  • Emergency Medicine Physician
  • Buffalo, NY
National Provider Identifier
1821353251
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
278801 Issued in NY
Practice address
462 Grider St
University Emergency Medical Services
Buffalo, NY 14215-3021
Phone
(716) 898-4430
Fax
(716) 898-4432
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 278801 NY Primary

Addresses

Primary practice location

462 Grider St
University Emergency Medical Services
Buffalo, NY 14215-3021

Mailing address

462 Grider St
University Emergency Medical Services
Buffalo, NY 14215-3021
Phone (716) 898-4430

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
I20150716002563 NY Practitioner - Emergency Medicine 7113145061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
76.13
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278801NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
University Emergency Medical Services Inc. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

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

Organizations & group practices 2

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1821353251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "address_2": "UNIVERSITY EMERGENCY MEDICAL SERVICES",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4430",
            "fax_number": "716-898-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "address_2": "UNIVERSITY EMERGENCY MEDICAL SERVICES",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4430",
            "fax_number": "716-898-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNES",
        "first_name": "JOHANNA",
        "middle_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "278801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.