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PHOENIX RISING MEDICAL, PC
NPI 1649470790
Internal Medicine - Pulmonary Disease in Williamsville, NY

Active since July 18, 2007
2829 WEHRLE DR STE 11A, WILLIAMSVILLE, NY 14221(716) 458-0069(716) 458-0061 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Phoenix Rising Medical, Pc NPPES

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

PHOENIX RISING MEDICAL, PC (NPI 1649470790) is a healthcare organization registered as a pulmonary disease in Williamsville, New York and active in the NPI registry since July 2007. The organization lists Tajuddin M Jiva, Owner, as its authorized official.

NPPES Registry Identity

NPI1649470790
Entity TypeOrganization
Primary Taxonomy207RP1001X
Legal Business NamePHOENIX RISING MEDICAL, PC
Location Address2829 WEHRLE DR STE 11AWilliamsville, NY 14221-7387
Mailing Address2829 Wehrle Dr Ste 11aWilliamsville, NY 14221-7387 · (716) 458-0069 · Fax (716) 458-0061
Phone(716) 458-0069
Fax(716) 458-0061
Organization SubpartNo
Authorized OfficialTajuddin M JivaOwner · (716) 334-9879
Enumeration DateJuly 18, 2007
Last NPPES UpdateFebruary 6, 2025
NPPES CertifiedFebruary 6, 2025
✔ NPI 1649470790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NY · 183042
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
2829 WEHRLE DR STE 11A, Williamsville, NY 14221
Open in Google Maps ↗

Other Identifiers 1

Medicaid01447790NY

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)

Phoenix Rising Medical, Pc 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 Phoenix Rising Medical, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tajuddin Jiva, MD MPH MBA
Pulmonary Disease
NPI 1598718983
2829 WEHRLE DR STE 11A
Williamsville, NY 14221
(716) 836-1388
✔ 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 Phoenix Rising Medical, PC's NPI number?

The NPI number for Phoenix Rising Medical, PC is 1649470790. It was assigned to this organization in the NPPES registry on July 18, 2007.

Where is Phoenix Rising Medical, PC located?

Phoenix Rising Medical, PC is located at 2829 Wehrle Dr Ste 11A, Williamsville, NY 14221. The listed phone number is (716) 458-0069.

What is Phoenix Rising Medical, PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Phoenix Rising Medical, PC enrolled in Medicare?

Yes. Phoenix Rising Medical, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Phoenix Rising Medical, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pulmonary Disease) reassigns their Medicare billing to Phoenix Rising Medical, PC. 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 Phoenix Rising Medical, PC was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.