Provider Demographics
NPI:1841258423
Name:BARTELS, MATTHEW F (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:F
Last Name:BARTELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 GARDENVILLE PKWY W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1324
Mailing Address - Country:US
Mailing Address - Phone:716-857-6150
Mailing Address - Fax:716-656-4074
Practice Address - Street 1:1185 SWEET HOME RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-689-0040
Practice Address - Fax:716-568-2330
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY227896208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0002616800OtherUNIVERA
NY1292572OtherIHA
NY02400122Medicaid
NY10904219OtherCAQH
NY159947DLOtherPREFERRED CARE
NY000528313001OtherBCBS
NY050808000024OtherFIDELIS