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WESTERN NEW YORK DERMATOLOGY, PLLC
NPI 1083030498
Specialist in Williamsville, NY

Active since March 10, 2014CLIA Certified · 2 labs
297 SPINDRIFT DR, WILLIAMSVILLE, NY 14221(716) 831-2600 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 23, 2020, Jan 6, 2020 (2 updates tracked since 2020).

About Western New York Dermatology, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WESTERN NEW YORK DERMATOLOGY, PLLC (NPI 1083030498) is a healthcare organization registered as a specialist in Williamsville, New York and active in the NPI registry since March 2014. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Williamsville, and lists Beverly Wittmeyer, Business Manager/consultant, as its authorized official.

NPPES Registry Identity

NPI1083030498
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameWESTERN NEW YORK DERMATOLOGY, PLLC
Location Address297 SPINDRIFT DRWilliamsville, NY 14221-7894
Mailing Address297 Spindrift DrWilliamsville, NY 14221-7894
Phone(716) 831-2600
Organization SubpartNo
Authorized OfficialBeverly WittmeyerBusiness Manager/consultant · (716) 831-2600
Enumeration DateMarch 10, 2014
Last NPPES UpdateOctober 23, 20202 updates tracked since enumeration
NPPES CertifiedOctober 23, 2020
✔ NPI 1083030498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
297 SPINDRIFT DR, Williamsville, NY 14221
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Secondary Practice Location 1

Location 1295 Spindrift DrWilliamsville, NY 14221 · Phone (716) 831-2600 ext. 118 · Fax (716) 831-2601

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2177762

Western New York Dermatology, PLLC · Williamsville, NY
Active · expires Jan 16, 2028
CLIA Number33D2177762
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2026
Certificate Expiration DateJanuary 16, 2028
Laboratory DirectorDr. Michael Nazareth
Laboratory Phone(716) 831-2600
Laboratory LocationWestern New York Dermatology, PLLC297 Spindrift Drive - Ste 100, Williamsville, NY 14221
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 33D2320163

Western New York Dermatology · Williamsville, NY
Active · expires Jun 2, 2027
CLIA Number33D2320163
Laboratory TypePhysician Office
Certificate Effective DateJune 3, 2025
Certificate Expiration DateJune 2, 2027
Laboratory DirectorDr. Andrew P. Sauvageau
Laboratory Phone(716) 831-2600
Laboratory LocationWestern New York Dermatology295 Spindrift Drive, Williamsville, NY 14221
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIC J KOCH DO
Internal Medicine
297 SPINDRIFT DR
WILLIAMSVILLE, NY 14221
Erie County (716) 635-0688
MICAELA LUCARELLI FNP-BC
Nurse Practitioner
297 SPINDRIFT DR
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600
COURTNEY WOLF
Nurse Practitioner (Family)
297 SPINDRIFT DR
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600
JESSICA MANCUSO FNP
Nurse Practitioner
297 SPINDRIFT DR
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600
DR. MICHAEL R NAZARETH M.D./PH.D.
Dermatology
297 SPINDRIFT DR, SUITE 100
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600
ROSALBA MUCCIARELLA MD
Internal Medicine
297 SPINDRIFT DR, STE 200
WILLIAMSVILLE, NY 14221
Erie County (716) 635-0688
KYLE HORTON-MASER
Nurse Practitioner
297 SPINDRIFT DR, SUITE 100
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600
KELLY LYNN MANGANELLO P.A.
Physician Assistant
297 SPINDRIFT DR
WILLIAMSVILLE, NY 14221
Erie County (716) 831-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Western New York Dermatology, PLLC's NPI number?

The NPI number for Western New York Dermatology, PLLC is 1083030498. It was assigned to this organization in the NPPES registry on March 10, 2014.

Where is Western New York Dermatology, PLLC located?

Western New York Dermatology, PLLC is located at 297 Spindrift Dr, Williamsville, NY 14221. The listed phone number is (716) 831-2600.

What is Western New York Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Western New York Dermatology, PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Western New York Dermatology, PLLC was last updated on October 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.