General Physician, PC
Organization Active NPI Clinic/Center · Ellicottville, NY
NPI 1003566233 · NPPES record last updated Jun 8, 2026
Key facts
- NPI
- 1003566233
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- GENERAL PHYSICIAN, PC
- Practice address
- 6133 Route 219 S Ste 1006
Ellicottville, NY 14731-9613 - Phone
- (716) 699-4332
- NPI assigned
- Mar 29, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- KALEIDA HEALTH
Authorized official
- Name
- Tabitha Abraham
- Title
- Director
- Phone
- (716) 533-4728
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 6
Practitioners 14
-
Puneet S Chahal, DPM
-
William Cihak, MD
-
Susan E. Dougherty, NP-CNM
-
Elayna Rose Dowd, NP
-
Laura A Pecorella, RPA-C
-
Mark J Welch, MD
-
Thaddeus Wojcik, M.D.
-
Sri Nidhi Ganji, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220603000542 | NY | Part B Supplier - Clinic/Group Practice | 0042698045 |
Receives reassigned benefits from 91 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cuba, NY; Ellicottville, NY; Franklinville, NY; Olean, NY; Salamanca, NY |
National Provider Directory
- Tax ID family
- Olean Medical Practice Coumadin Clinic
- Part of
- Mary George
Locations
14 Center St
Cuba, NY 14727
Phone (585) 968-3210
6133 Route 219 S
Ste 600
Ellicottville, NY 14731
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6edd93a1-7391-4938-bcd9-ebe248fd573e/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
6133 Route 219 S Ste 1006
Ellicottville, NY 14731-9613
Mailing address
535 Main St
Olean, NY 14760-1500
Phone (716) 372-0141
Other names
- Olean Medical Group
Other providers in Ellicottville, NY
- Ellicottville Medical
- Ellicottville Oasis Day Spa Inc.
- Ellicottville Optical Inc.
- Ellicottville Pharmacy Inc
- Ellicottville Pharmacy Inc
- Diana Marie Golley
- Leaudra Hackett
- Katelyn Elizabeth Johnson-Clark
- Darla Jean Kent
- Margaret Helen Kent
All providers in Ellicottville, NY · Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.