Individual provider Active NPI

David Baskerville

  • Medical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1952142366
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
032085 Issued in NY
Practice address
40 George Karl Blvd
Williamsville, NY 14221-7183
Phone
(716) 218-1000
NPI assigned
Jun 3, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 032085 NY Primary

Addresses

Primary practice location

40 George Karl Blvd
Williamsville, NY 14221-7183

Mailing address

40 George Karl Blvd
Williamsville, NY 14221-7183
Phone (716) 218-1000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809002375 NY Practitioner - Physician Assistant 7113465022 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
032085NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Neurosurgery, Inc. Single Specialty CurrentSince Aug 12, 2024 Accepting new patients
Eastern Great Lakes Pathology PC Single Specialty Current Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Single Specialty Current Accepting new patients

Locations

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

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

40 George Karl Blvd
Williamsville, NY 14221

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, 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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1952142366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GEORGE KARL BLVD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217183",
            "telephone_number": "716-218-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GEORGE KARL BLVD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217183",
            "telephone_number": "716-218-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKERVILLE",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "032085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.