Individual provider Active NPI

Mary Angela McLellan-Desai, MD

  • Obstetrics & Gynecology Physician
  • Amherst, NY
National Provider Identifier
1841257177
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
229046 Issued in NY
Practice address
705 Maple Rd
Amherst, NY 14221-3291
Phone
(716) 656-4077
Fax
(716) 458-0271
NPI assigned
Apr 28, 2006
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 229046 NY Primary

Addresses

Primary practice location

705 Maple Rd
Amherst, NY 14221-3291

Mailing address

PO Box 488
Buffalo, NY 14240-0488
Phone (203) 944-1940

Other identifiers 1

IdentifierTypeStateIssuer
02461329MedicaidNY

Other names 1

  • Angela Desai Former name

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
I20050204000498 NY Practitioner - Obstetrics/Gynecology 5395795991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Buffalo School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229046NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince May 30, 2010 Accepting new patients

Locations

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

4845 Transit Rd
Depew, NY 14043
Phone (716) 656-2200

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

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

Interoperability endpoints

  • Direct secure messaging: drmclellan@gppc.medentdirect.com

Organizations & group practices 1

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 6

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1841257177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "203-944-1940",
            "fax_number": "203-402-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAPLE RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142213291",
            "telephone_number": "716-656-4077",
            "fax_number": "716-458-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN-DESAI",
        "first_name": "MARY ANGELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "229046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02461329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DESAI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.