Individual provider Active NPI

Mustafa Mohmand, M.D.

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1871099085
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
318655 Issued in NY
Practice address
1091 Main St
Buffalo, NY 14209-2305
Phone
(716) 248-1420
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 318655 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1091 Main St
Buffalo, NY 14209-2305

Mailing address

1091 Main St
Buffalo, NY 14209-2305
Phone (716) 248-1420

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
I20221004002991 NY Practitioner - Family Practice 8820335250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
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)

1091 Main St
Suite 301
Buffalo, NY 14209-2305
Phone (716) 362-0328

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318655NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

1091 Main St
Buffalo, NY 14209
Phone (716) 242-8200

1091 Main St
Ste 301
Buffalo, NY 14209
Phone (716) 248-1420

1091 Main St
Ste 301GP
Buffalo, NY 14209

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

Interoperability endpoints

  • Direct secure messaging: mmohmand@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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1871099085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092305",
            "telephone_number": "716-248-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092305",
            "telephone_number": "716-248-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHMAND",
        "first_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "318655",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.