NPIMap

Individual provider Active NPI

Jeffery Jerome Grace, M.D.

  • Psychiatry Physician
  • Buffalo, NY
National Provider Identifier
1841247921
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
163371 Issued in NY
Practice address
2949 Elmwood Ave Ste 201
Buffalo, NY 14217-1356
Phone
(716) 907-4675
Fax
(716) 882-1229
NPI assigned
May 27, 2006
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 163371 NY Primary

Addresses

Primary practice location

2949 Elmwood Ave Ste 201
Buffalo, NY 14217-1356

Mailing address

400 Forest Ave
Buffalo, NY 14213-1207
Phone (716) 816-2003

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
I20100728000546 NY Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 5597898536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Niagara Falls Memorial Medical CenterGroup PAC ID 0244134484, shared by 2 NPIs, 67 clinicians

Practice addresses (Care Compare)

621 10TH St
Niagara Falls, NY 14301-1813
Phone (716) 278-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center CurrentSince May 1, 2021 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince May 1, 2021 Accepting new patients
Sadashiv S Shenoy MD PLLC CurrentSince Dec 10, 2023 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Apr 1, 2023 Accepting new patients
Mental Health Services-Erie County Northwest Corporation I PastSince Oct 4, 1999 Accepting new patients

Locations

2949 Elmwood Ave
Ste 201
Kenmore, NY 14217
Phone (716) 877-0053

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1841247921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FOREST AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131207",
            "telephone_number": "716-816-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 ELMWOOD AVE STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142171356",
            "telephone_number": "716-907-4675",
            "fax_number": "716-882-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "JEFFERY",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "163371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.