JESSICA PATHROSE DO – NPI #1669095477
Pediatrics

A pediatrician who has special qualifications to manage emergencies in infants and children.

JESSICA PATHROSE is a physician located in WILLIAMSVILLE, NY. NPPES has assigned the NPI number 1669095477 to JESSICA PATHROSE on May 27, 2020. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 3 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2080P0204X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Pediatric Emergency Medicine

The NPI profile was last updated on Apr 01, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JESSICA PATHROSE below.

NPI Profile for
JESSICA PATHROSE

NPI Number
1669095477
Enumeration Date

(more than 6 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
JESSICA PATHROSE
Credentials
DO
Primary location
1800 MAPLE RD STE 100
WILLIAMSVILLE, NY 14221-2749
Phone: (716) 636-5437 Fax:
3 Other location(s):
3055 Southwestern Blvd Ste 104
Orchard Park, NY 14127-1231
Phone: (716) 636-5437 Ext: 217
1425 Portland Ave
Rochester, NY 14621-3011
Phone: (585) 922-2000
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone: (210) 704-3030
Mailing address
31 FARGO AVE LOWR FRONT
BUFFALO, NY 14201-1768
Phone: (214) 957-3060 Fax:
Sole Proprietor
No
Updated
Certification Date
Apr 01, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080P0204X
- Pediatrics / Pediatric Emergency Medicine (Primary)
TX W4924
208000000X
- Pediatrics
TX W4924

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE - Graduated 2020
Accepts Medicare
This provider may accept Medicare Assignment. The Medicare-approved amount is the total the doctor or supplier can be paid. When a doctor accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsurance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.