Demetra McIlwain, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

319236 Issued in NY

Practice address

21 Doat St
Buffalo, NY 14211-1612

Phone

(716) 892-2775

Fax

(716) 597-0554

NPI assigned

Apr 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jericho Road Ministries, Inc.Group PAC ID 5597992933, 33 clinicians

Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: demetra.mcilwain@jrchc.medentdirect.com

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.

• Erie County Medical Center Corporation

  • Clinic/Center
  • Buffalo, NY
  • NPI 1528233616
  Medicare reassignment Care Compare group NPD
• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1972944080
  Medicare reassignment Care Compare group NPD
• Ub Family Medicine, Inc

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  Medicare reassignment NPD
• Erie County Medical Center Corporation

  • Community/Retail Pharmacy
  • Buffalo, NY
  • NPI 1922768621
  NPD
• Jericho Road Ministries, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1952893091
  NPD
• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  NPD
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1245365196
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Erie County Medical Center Corporation

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1437197985
  Care Compare affiliation

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1871056002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DOAT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142111612",
            "telephone_number": "716-892-2775",
            "fax_number": "716-597-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DOAT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142111612",
            "telephone_number": "716-892-2775",
            "fax_number": "716-597-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "DEMETRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "319236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin McGuire
• Kayleah McGuire
• Rosemarie Ann McGuire, NP
• Laurie M McHenry, CASAC
• Rosemarie McHugh, MS, ANP-C
• Nicole McIlwain
• Alliyah Kai McIntosh
• Frederick Michael McIntyre, DDS
• Virginia McIntyre
• Madeline McKay

• Family Medicine Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.