Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lydia Marie Wishman

Individual provider Gerontology Nurse Practitioner · NPI 1275498628

Lydia Marie Wishman is a Nurse Practitioner in Buffalo, New York. Qualified in 2025, 1 year ago. Practices with Roswell Park Cancer Institute, a 489-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
Specialties on file
2

Practice location Address checks out

665 Elm St
Buffalo, NY 14203-1104
Phone: (716) 341-5504
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Elm And Carlton St, Buffalo, NY 14263-0001 — (716) 845-2300

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 312201-01 (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence 312201-01 (NY)

Record details

NPI number1275498628
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 18, 2025
Last updated in NPPESDecember 18, 2025
Certification dateDecember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Roswell Park Cancer Institute — 489 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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