Individual provider Active NPI

Mary E Schuetz, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • East Aurora, NY
National Provider Identifier
1861453177
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
1703961 Issued in NY
Practice address
679 Main St
Rear Suite
East Aurora, NY 14052-2404
Phone
(716) 805-0755
Fax
(716) 805-0126
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1703961 NY
Developmental - Behavioral Pediatrics Physician 2080P0006X 1703961 NY
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 1703961 NY Primary

Addresses

Primary practice location

679 Main St
Rear Suite
East Aurora, NY 14052-2404

Mailing address

679 Main St
Rear Suite
East Aurora, NY 14052-2404
Phone (716) 805-0755

Other identifiers 1

IdentifierTypeStateIssuer
01477590MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1703961NYMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seedling Developmental, Inc. Neurodevelopmental Disabilities Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1861453177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 MAIN ST",
            "address_2": "REAR SUITE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522404",
            "telephone_number": "716-805-0755",
            "fax_number": "716-805-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 MAIN ST",
            "address_2": "REAR SUITE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522404",
            "telephone_number": "716-805-0755",
            "fax_number": "716-805-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUETZ",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "1703961",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "1703961",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "1703961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01477590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.