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PURE PODIATRY OF WNY PLLC
NPI 1114382520
Podiatrist in Buffalo, NY

Active since December 30, 2015
1431 HERTEL AVE, BUFFALO, NY 14216(716) 897-3720(716) 897-3918 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2024, Dec 30, 2015 (2 updates tracked since 2015).

About Pure Podiatry Of Wny Pllc NPPES

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

PURE PODIATRY OF WNY PLLC (NPI 1114382520) is a healthcare organization registered as a podiatrist in Buffalo, New York and active in the NPI registry since December 2015. The organization lists Breeann N Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1114382520
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NamePURE PODIATRY OF WNY PLLC
Location Address1431 HERTEL AVEBuffalo, NY 14216-2871
Mailing Address1431 Hertel AveBuffalo, NY 14216-2871 · (716) 897-3720 · Fax (716) 897-3918
Phone(716) 897-3720
Fax(716) 897-3918
Organization SubpartNo
Authorized OfficialBreeann N WilsonOwner · (716) 897-3720
Enumeration DateDecember 30, 2015
Last NPPES UpdateSeptember 17, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2024
✔ NPI 1114382520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in NY · 006328
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
1431 HERTEL AVE, Buffalo, NY 14216
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Other Identifiers 1

Medicaid04485329NY

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pure Podiatry Of Wny Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pure Podiatry Of Wny PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Breeann Wilson, DPM
Podiatry
NPI 1255573887
1431 HERTEL AVE
Buffalo, NY 14216
(716) 897-3720
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Pure Podiatry Of Wny PLLC's NPI number?

The NPI number for Pure Podiatry Of Wny PLLC is 1114382520. It was assigned to this organization in the NPPES registry on December 30, 2015.

Where is Pure Podiatry Of Wny PLLC located?

Pure Podiatry Of Wny PLLC is located at 1431 Hertel Ave, Buffalo, NY 14216. The listed phone number is (716) 897-3720.

What is Pure Podiatry Of Wny PLLC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Pure Podiatry Of Wny PLLC enrolled in Medicare?

Yes. Pure Podiatry Of Wny PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pure Podiatry Of Wny PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Pure Podiatry Of Wny PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pure Podiatry Of Wny PLLC was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.