Individual provider Active NPI

Nicholas Smothermon, DO

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1912692633
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
342132 Issued in NY
Practice address
301 Connecticut St
Buffalo, NY 14213-2541
Phone
(716) 862-2572
NPI assigned
Apr 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 342132 NY Primary

Addresses

Primary practice location

301 Connecticut St
Buffalo, NY 14213-2541

Mailing address

301 Connecticut St
Buffalo, NY 14213-2541
Phone (716) 862-2572

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
I20260609002224 NY Practitioner - Internal Medicine 4981175007

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

144 Genesee St
FL 3
Buffalo, NY 14203-1510

144 Genesee St
Revenue Management 3Rd Floor
Buffalo, NY 14203-1560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
342132NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1912692633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CONNECTICUT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132541",
            "telephone_number": "716-862-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CONNECTICUT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132541",
            "telephone_number": "716-862-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMON",
        "first_name": "NICHOLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "342132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.