Individual provider Active NPI

Edward Ted Fitzpatrick, DPM

  • Foot & Ankle Surgery Podiatrist
  • Williamsville, NY
National Provider Identifier
1972664449
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006292 Issued in NY
Practice address
6325 Main St
Suite 200
Williamsville, NY 14221-5822
Phone
(716) 839-3930
Fax
(716) 839-2667
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103300945 VA
Podiatrist 213E00000X 1144 MA
Foot & Ankle Surgery Podiatrist 213ES0103X N006292 NY Primary

Addresses

Primary practice location

6325 Main St
Suite 200
Williamsville, NY 14221-5822

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081202000425 NY Practitioner - Podiatry 1658398318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Ohio State University - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

85 High St
Buffalo, NY 14203-1149
Phone (716) 630-1000

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue30
Removal of skin lesions50
Removal of nail tissue835
Removal or shaving of skin growth218
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1144MAMDRegistered Dietitian
0103300945VAMDPodiatrist
N006292NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Apr 1, 2017 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Mar 1, 2015 Accepting new patients
Kaleida Health Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Mar 1, 2015 Accepting new patients
Kaleida Health CurrentSince Apr 1, 2017 Accepting new patients

Locations

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

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

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

6325 Main St
Ste 200
Williamsville, NY 14221
Phone (716) 630-1295

Interoperability endpoints

  • Direct secure messaging: efitzpatrick5128@direct.buffalomedicalgroup.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1972664449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219",
            "fax_number": "716-817-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 MAIN ST",
            "address_2": "SUITE 200",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215822",
            "telephone_number": "716-839-3930",
            "fax_number": "716-839-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "EDWARD",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103300945",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1144",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.