Active NPI
Matthew J O Brien, MD
- Internal Medicine Physician
- Buffalo, NY
National Provider Identifier
1972551430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 141215-1
- Practice address
- 85 High St
Buffalo, NY 14203-1149 - Phone
- (716) 857-8616
- Fax
- (716) 250-5945
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 141215-1 | NY | Primary |
Addresses
Primary practice location
85 High St
Buffalo, NY 14203-1149
Mailing address
6255 Sheridan Dr
Suite 304
Williamsville, NY 14221-4836
Phone (716) 857-8666
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141215-4W | Other | NY | WORKERS COMPENSATION |
| 000508257001 | Other | NY | HEALTH NOW |
| 0403994 | Other | NY | IHA |
| 00010129001 | Other | NY | UNIVERA |
| 00644546 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 141215-1 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208131200000",
"number": "1972551430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 SHERIDAN DR",
"address_2": "SUITE 304",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214836",
"telephone_number": "716-857-8666",
"fax_number": "716-857-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 HIGH ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142031149",
"telephone_number": "716-857-8616",
"fax_number": "716-250-5945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O BRIEN",
"first_name": "MATTHEW",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2008-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "141215-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION",
"identifier": "141215-4W",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NOW",
"identifier": "000508257001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA",
"identifier": "0403994",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00010129001",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00644546",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.