Individual provider Active NPI

Malcolm C McIsaac, MD

  • Ophthalmology Physician
  • Orchard Park, NY
National Provider Identifier
1962771667
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
097349 Issued in NY
Practice address
205 Elmhurst Dr
Orchard Park, NY 14127-2940
Phone
(716) 662-4261
NPI assigned
Dec 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 097349 NY Primary

Addresses

Primary practice location

205 Elmhurst Dr
Orchard Park, NY 14127-2940

Mailing address

205 Elmhurst Dr
Orchard Park, NY 14127-2940
Phone (716) 662-4261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
097349NYMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962771667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ELMHURST DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272940",
            "telephone_number": "716-662-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ELMHURST DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272940",
            "telephone_number": "716-662-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "MALCOLM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "097349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.