NPIMap

Individual provider Active NPI

Victor S Regenbogen, MD

  • Diagnostic Radiology Physician
  • Williamsville, NY
National Provider Identifier
1871550012
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
171549 Issued in NY
Practice address
111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178
Phone
(716) 836-4646
Fax
(716) 859-2962
NPI assigned
May 1, 2006
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 171549 NY Primary

Addresses

Primary practice location

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178

Mailing address

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178
Phone (716) 836-4646

Other identifiers 15

IdentifierTypeStateIssuer
000911571014OtherBLUE SHIELD WNY
101203FFOtherPREFERRED CARE
4195928OtherGHI
040426003059OtherFIDELIS
1715499BOtherNYWORKERS COMPENSATION
000911571011OtherBLUE SHIELD WNY
01044453MedicaidNY
1693153OtherINDEPENDENT HEALTH
P00136831OtherRR MEDICARE
P010171549OtherBLUE CHOICE
00026030202OtherUNIVERA
00026030204OtherUNIVERA
0142857OtherGHI
P00029526OtherRR MEDICARE
P020171549OtherBLUE SHIELD ROCHESTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070522000333 NY Practitioner - Diagnostic Radiology 1759270978 Reassigns benefits to 7 organizations
I20201203001557 PA Practitioner - Diagnostic Radiology 1759270978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Radiology Associates LLCGroup PAC ID 3072402296, 27 clinicians
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians
Bradford Radiology PCGroup PAC ID 5890198840, 21 clinicians
Great Lakes Medical Imaging LLCGroup PAC ID 2163681859, 42 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 332-8078

116 Interstate Pkwy
Bradford, PA 16701-1036
Phone (814) 368-4143

3085 Harlem Rd
Suite 150
Cheektowaga, NY 14225-2593
Phone (716) 844-5300

515 Main St
Olean, NY 14760-1513
Phone (716) 373-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
45.23 of 100Reported as group
Quality
27.79
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
77.6 of 100Reported as individual
Quality
81.55
Improvement activities
0
Cost
75.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171549NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olean Medical Practice PLLC Current Accepting new patients
Western New York Radiology Associates LLC Diagnostic Radiology CurrentSince Mar 1, 2003 Accepting new patients
University Orthopaedic Services Inc. CurrentSince Nov 1, 2024 Accepting new patients
University Orthopaedic Services, Inc CurrentSince Nov 1, 2024 Accepting new patients
General Physician, PC CurrentSince Oct 1, 2024 Accepting new patients
General Physician, PC CurrentSince Oct 1, 2024 Accepting new patients
Olean Radiology, PC Diagnostic Radiology CurrentSince Oct 15, 2020 Accepting new patients
Great Lakes Medical Imaging LLC Diagnostic Radiology CurrentSince Mar 1, 2012 Accepting new patients
Lakeside Imaging, LLC Diagnostic Radiology Past Accepting new patients
Borg & Ide Imaging, PC Diagnostic Radiology PastSince Aug 6, 1997 Accepting new patients
Northtowns Imaging PC Diagnostic Radiology Past Accepting new patients
Northtowns Imaging PC Diagnostic Radiology Past Accepting new patients
Advanced Digestive Care P a Past Accepting new patients

Locations

156 West Ave
Brockport, NY 14420
Phone (585) 395-6095

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

160 Farber Hall
Buffalo, NY 14214
Phone (716) 829-2070

4949 Harlem Rd
Buffalo, NY 14226
Phone (716) 204-3201

3085 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 150
Cheektowaga, NY 14225
Phone (716) 844-5300

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

4693 Commercial Dr
New Hartford, NY 13413
Phone (315) 507-5114

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

515 Main St
Olean, NY 14760
Phone (716) 373-2600

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

500 Sterling Dr
#2
Orchard Park, NY 14127

5959 Big Tree Rd
Ste 105
Orchard Park, NY 14127
Phone (716) 256-1114

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

3850 Saunders Settlement Rd
Ste 150
Sanborn, NY 14132

1116 Arsenal St
Ste 504
Watertown, NY 13601
Phone (315) 782-2669

111 N Maplemere Rd
Ste 120
Williamsville, NY 14221
Phone (716) 836-4646

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

199 Park Club Ln
Ste 300
Williamsville, NY 14221
Phone (716) 332-8074

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1871550012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 120",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213178",
            "telephone_number": "716-836-4646",
            "fax_number": "716-859-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 120",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213178",
            "telephone_number": "716-836-4646",
            "fax_number": "716-859-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGENBOGEN",
        "first_name": "VICTOR",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "171549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD WNY",
            "identifier": "000911571014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "101203FF",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "4195928",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426003059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "1715499B",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD WNY",
            "identifier": "000911571011",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01044453",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "1693153",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00136831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010171549",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026030202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026030204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0142857",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00029526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ROCHESTER",
            "identifier": "P020171549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.