Gerard Tiballi, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

176342 Issued in NY

Practice address

3980 Sheridan Dr
Amherst, NY 14226-1727

Phone

(716) 729-2800

Fax

(716) 929-2819

NPI assigned

May 25, 2006

Last updated

Oct 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

R Franklin University of Med & Sci/Chicago Medical School, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western New York Immediate Medical Care LLCGroup PAC ID 9537105283, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Western New York Immediate Medical Care LLC

  dba WNY Immediate Care

  • Urgent Care Clinic/Center
  • Williamsville, NY
  • NPI 1316014491
  Medicare reassignment Care Compare group NPD
• Trinity Medical Wny PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1295043149
  Medicare reassignment NPD
• Trinity Medical Wny PC

  • Vascular Surgery Physician
  • Buffalo, NY
  • NPI 1205468055
  NPD
• Western New York Immediate Medical Care LLC

  • Emergency Medicine Physician
  • Orchard Park, NY
  • NPI 1427224625
  NPD
• Buffalo Emergency Associates LLP

  • Emergency Medicine Physician
  • Williamsville, NY
  • NPI 1508816521
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1912953761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FOUNTAIN PLAZA",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142022211",
            "telephone_number": "716-691-8838",
            "fax_number": "716-204-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-729-2800",
            "fax_number": "716-929-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBALLI",
        "first_name": "GERARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "176342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354049",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Thompson, MD
• Lisa F Thorpe, OTR
• Thrive Nutrition & Wellness, LLC
• Thrive Well NP in Adult Health PLLC
• Denise M Thurston, D.C.
• Britton Edgett Tisdale, M.D., B.SC.PHM.
• Allison Tobias
• Todd E Plinke DC, PC
• Esther C Toepfer, DDS
• Alan Jeffrey Tolchin, MD

• Emergency Medicine Physician in Amherst, NY
• Providers in Amherst, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.