NPIMap

Individual provider Active NPI

David Robert Deberny, M.D.

  • Internal Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1861456642
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
189581 Issued in NY
Practice address
3560 N Buffalo St
Orchard Park, NY 14127-1934
Phone
(716) 662-8510
Fax
(716) 662-8574
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 189581 NY Primary
Pediatrics Physician 208000000X 189581 NY

Addresses

Primary practice location

3560 N Buffalo St
Orchard Park, NY 14127-1934

Mailing address

3560 N Buffalo St
Orchard Park, NY 14127-1934
Phone (716) 662-8510

Other identifiers 1

IdentifierTypeStateIssuer
01470075MedicaidNY

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
I20110516000092 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6406032143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quaker Medical Associates PCGroup PAC ID 4486600517, 7 clinicians

Practice addresses (Care Compare)

3560 N Buffalo St
Orchard Park, NY 14127-1934
Phone (716) 662-8510

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quaker Medical Associates, PC Internal Medicine CurrentSince Jan 1, 1996 Accepting new patients

Locations

3560 N Buffalo St
Orchard Park, NY 14127
Phone (716) 662-8510

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.

Hospital & facility affiliations 9

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1861456642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271934",
            "telephone_number": "716-662-8510",
            "fax_number": "716-662-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271934",
            "telephone_number": "716-662-8510",
            "fax_number": "716-662-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERNY",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "189581",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01470075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.