Individual provider Active NPI

Bronson Yaldoo, DO

  • Diagnostic Radiology Physician
  • Orchard Park, NY
National Provider Identifier
1881005759
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101021116 Issued in MI
Practice address
3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone
(716) 630-1112
NPI assigned
May 14, 2014
Last updated
May 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 5101021116 MI Primary

Addresses

Primary practice location

3900 N Buffalo St
Orchard Park, NY 14127-1842

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Other practice location 1

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200610000488 MI Practitioner - Diagnostic Radiology 4082834973 Reassigns benefits to 2 organizations
I20220526000834 NY Practitioner - Diagnostic Radiology 4082834973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

295 Essjay Rd
Williamsville, NY 14221-8216
Phone (716) 630-1000

3900 N Buffalo St
Orchard Park, NY 14127-1842
Phone (716) 630-1000

6950 S Transit Rd
Lockport, NY 14094-6333
Phone (716) 630-1000

85 High St
Buffalo, NY 14203-1149
Phone (716) 630-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
316768NYMDLicensed Practical Nurse
5101021116MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Oakland North Macomb Imaging CurrentSince Jul 3, 2020 Accepting new patients
Southfield Rehabilitation Company Diagnostic Radiology CurrentSince May 24, 2021 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince May 16, 2022 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince May 16, 2022 Accepting new patients
Southfield Rehabilitation Company Diagnostic Radiology CurrentSince May 24, 2021 Accepting new patients

Locations

3100 Cross Creek Pkwy
Ste 120
Auburn Hills, MI 48326
Phone (248) 327-8980

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 631-2517

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1881005759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271842",
            "telephone_number": "716-630-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Perry St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483422217",
            "country_code": "US",
            "telephone_number": "248-338-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YALDOO",
        "first_name": "BRONSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101021116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "3900 N Buffalo St",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "141271842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.