Individual provider Active NPI

Adelia Sazonov, D.O.

  • Psychiatry Physician
  • Williamsville, NY
National Provider Identifier
1871930701
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
287305 Issued in NY
Practice address
8207 Main St Ste 7&8
Williamsville, NY 14221-6060
Phone
(716) 626-4200
Fax
(716) 626-4201
NPI assigned
Jun 1, 2013
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 287305 NY Primary

Addresses

Primary practice location

8207 Main St Ste 7&8
Williamsville, NY 14221-6060

Mailing address

3396 Driftwood Rd
Bemus Point, NY 14712-9705

Other practice location 1

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-4221

Other practice location 2

400 N Main St
Warsaw, NY 14569-1025
Phone (585) 786-1249

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
I20170720002598 NY Practitioner - PsychiatryPractitioner - Neuropsychiatry 3678843885 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neuropsychiatry
Education
New York College of Osteo Medicine of New York Institute of Technology, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dent Neurologic Group LLPGroup PAC ID 1951298033, 117 clinicians
Olean General HospitalGroup PAC ID 9133111784, 78 clinicians

Practice addresses (Care Compare)

3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 250-2000

515 Main St
Olean, NY 14760-1513
Phone (716) 375-6993

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Psychiatric PC Psychiatry CurrentSince Jul 25, 2023 Accepting new patients
Olean General Hospital CurrentSince Jul 8, 2024 Accepting new patients
Brooks-TLC Hospital System, Inc. CurrentSince Nov 14, 2018 Accepting new patients
Dent Neurologic Group LLP Psychiatry CurrentSince Feb 9, 2023 Accepting new patients
Olean General Hospital CurrentSince Jul 8, 2024 Accepting new patients
County of Chautauqua - a Mun Corp CurrentSince Dec 16, 2019 Accepting new patients
County of Chautauqua - a Mun Corp CurrentSince Dec 16, 2019 Accepting new patients
Olean General Hospital Past Accepting new patients
Olean General Hospital Past Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

34 Commercial St
Gowanda, NY 14070
Phone (716) 532-3377

1465 Foote Avenue Ext
Jamestown, NY 14701
Phone (716) 526-4041

200 E 3rd St
Ste 5
Jamestown, NY 14701
Phone (716) 661-8330

3 N Erie St
Mayville, NY 14757

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

515 Main St
#13282
Olean, NY 14760
Phone (716) 375-6993

4039 Route 219
Ste 101
Salamanca, NY 14779
Phone (716) 945-0361

3980 Sheridan Dr
Snyder, NY 14226
Phone (716) 929-2800

Interoperability endpoints

  • Direct secure messaging: adelia.sazonov@dent.eclinicaldirectplus.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1871930701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 DRIFTWOOD RD",
            "city": "BEMUS POINT",
            "state": "NY",
            "postal_code": "147129705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 MAIN ST STE 7&8",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216060",
            "telephone_number": "716-626-4200",
            "fax_number": "716-626-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Grider St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142153021",
            "country_code": "US",
            "telephone_number": "716-898-4221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Main St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NY",
            "postal_code": "145691025",
            "country_code": "US",
            "telephone_number": "585-786-1249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAZONOV",
        "first_name": "ADELIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-01",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "287305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.