Provider Demographics
NPI:1164464921
Name:MERCY HOSPITAL OF BUFFALO
Entity type:Organization
Organization Name:MERCY HOSPITAL OF BUFFALO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:MACHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-862-2430
Mailing Address - Street 1:565 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2039
Mailing Address - Country:US
Mailing Address - Phone:716-826-7000
Mailing Address - Fax:
Practice Address - Street 1:565 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:716-826-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0404X
NY1401008H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14OtherINDEPENDENT HEALTH
NY00354412Medicaid
NY00011412901OtherUNIVERA HEALTHCARE
NY040401000064OtherFIDELIS
NY070OtherHEALTHNOW
NY73OtherINDEPENDENT HEALTH
NY040401000064OtherFIDELIS
NY330279Medicare ID - Type Unspecified