Individual provider Active NPI

Logan Keith Walker, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1912535113
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
322256 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3098
Phone
(407) 461-9030
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 322256 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3098

Mailing address

462 Grider St
Buffalo, NY 14215-3098
Phone (407) 461-9030

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
I20230703001376 NY Practitioner - Family Practice 8820411366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322256NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Family Medicine CurrentSince Jul 15, 2023 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 4, 2023 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 4, 2023 Accepting new patients
University Emergency Medical Services Inc. Current Accepting new patients

Locations

77 Goodell St
Ste 240
Buffalo, NY 14203
Phone (716) 816-7228

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

Interoperability endpoints

  • Direct secure messaging: logan.walker.1@17278.direct.athenahealth.com

Organizations & group practices 4

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

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1912535113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153098",
            "telephone_number": "407-461-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153098",
            "telephone_number": "407-461-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LOGAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "322256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.