Organization Active NPI

CCS Medical, PLLC

  • Medical Oncology Physician
  • Williamsville, NY
National Provider Identifier
1013263052
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
CCS MEDICAL, PLLC
Practice address
45 Spindrift Dr
Suite 100
Williamsville, NY 14221-7889
Phone
(716) 565-0355
NPI assigned
Jul 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Won Sam Yi, MD
Title
Owner/President
Phone
(716) 655-2690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RX0202X Primary

Addresses

Primary practice location

45 Spindrift Dr
Suite 100
Williamsville, NY 14221-7889

Mailing address

45 Spindrift Dr
Suite 100
Williamsville, NY 14221-7889
Phone (716) 565-0355

Other identifiers 1

IdentifierTypeStateIssuer
03493785MedicaidNY

National Provider Directory

National Provider Directory

Locations

3800 Delaware Ave
Ste 104
Kenmore, NY 14217
Phone (716) 873-3828

626 Frankhauser Rd
Williamsville, NY 14221
Phone (716) 276-9162

2318 Wehrle Dr
Williamsville, NY 14221
Phone (716) 633-1112

1150 Youngs Rd
Ste 208
Williamsville, NY 14221

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1013263052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SPINDRIFT DR",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217889",
            "telephone_number": "716-565-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SPINDRIFT DR",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217889",
            "telephone_number": "716-565-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCS MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "WON",
        "authorized_official_middle_name": "SAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "716-655-2690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03493785",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.