Individual provider Active NPI

James Raymond Hereth, M.D.

  • Pediatric Critical Care Medicine Physician
  • Buffalo, NY
National Provider Identifier
1912161530
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
247895 Issued in NY
Practice address
818 Ellicott St
Buffalo, NY 14203-1021
Phone
(716) 323-0200
Fax
(716) 323-0293
NPI assigned
Jul 13, 2008
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247895 NY
Pediatric Critical Care Medicine Physician 2080P0203X 247895 NY Primary

Addresses

Primary practice location

818 Ellicott St
Buffalo, NY 14203-1021

Mailing address

1001 Main St FL 4
Buffalo, NY 14203-1009
Phone (716) 323-0200

Other identifiers 1

IdentifierTypeStateIssuer
03103335MedicaidNY

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
I20090708000011 NY Practitioner - Internal Medicine 6507917341 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

445 Tremont St
North Tonawanda, NY 14120-6150
Phone (716) 694-4500

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247895NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health CurrentSince Jul 1, 2011 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Kaleida Health Current Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
University at Buffalo Pediatric Associates Inc CurrentSince Jul 1, 2011 Accepting new patients
Kaleida Health CurrentSince Jul 1, 2011 Accepting new patients
Kaleida Health Past Accepting new patients
University Gynecologists & Obstetricians,Inc. PastSince Jul 24, 2022 Accepting new patients

Locations

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

100 High St
#13282
Buffalo, NY 14203

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

219 Bryant St
Buffalo, NY 14222
Phone (716) 878-7000

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

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

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

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 12

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 8

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": "1215907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1912161530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0200",
            "fax_number": "716-323-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ELLICOTT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031021",
            "telephone_number": "716-323-0200",
            "fax_number": "716-323-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERETH",
        "first_name": "JAMES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-13",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247895",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "247895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03103335",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.