NPIMap

Organization Active NPI

Parkside Medical Anesthesia Associates

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1871537464
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PARKSIDE MEDICAL ANESTHESIA ASSOCIATES
Practice address
2157 Main Street
Buffalo, NY 14214
Phone
(716) 836-7510
Fax
(716) 836-7511
NPI assigned
Jun 15, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mr. Jason Conant
Title
Practice Administrator
Phone
(716) 836-7510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

2157 Main Street
Buffalo, NY 14214

Mailing address

3871 Harlem Road
Suite 202
Buffalo, NY 14215
Phone (716) 836-7510

Other identifiers 1

IdentifierTypeStateIssuer
02190696MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000453 NY Part B Supplier - Clinic/Group Practice 7517854631 Receives reassigned benefits from 116 practitioners
Practice locations: Buffalo, NY

National Provider Directory

National Provider Directory

Locations

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

Practitioners & affiliated clinicians

Practitioners 156

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 156

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1871537464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 HARLEM ROAD",
            "address_2": "SUITE 202",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE MEDICAL ANESTHESIA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "CONANT",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "716-836-7510",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02190696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.