NPIMap

Individual provider Active NPI

Michael Henry Kueker, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1013414986
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301772 Issued in NY
Practice address
40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone
(716) 893-1010
Fax
(716) 893-1002
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 301772 NY Primary

Addresses

Primary practice location

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344

Mailing address

40 La Riviere Dr Ste 201
Buffalo, NY 14202-4344
Phone (716) 893-1010

Other practice location 1

11 Murray Hill Dr
Mount Morris, NY 14510-1153
Phone (585) 243-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200228000863 NY Practitioner - Family Practice 2860739257 Reassigns benefits to 2 organizations
I20220110002020 VT Practitioner - Family Practice 2860739257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Mobile Medical Care PCGroup PAC ID 8426575325, 97 clinicians
Mobile Physician Services PLLCGroup PAC ID 8325360290, 104 clinicians

Practice addresses (Care Compare)

Buffalo, NY 14202
Phone (716) 893-1010

40 La Riviere Dr
Suite 140
Buffalo, NY 14202-4306
Phone (716) 893-1010

98 Starr Farm Rd
Burlington, VT 05408-1323
Phone (802) 658-6717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
301772NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Mobile Medical Care PC CurrentSince Apr 1, 2025 Accepting new patients
Mobile Physician Services PLLC Family Medicine CurrentSince Jan 17, 2020 Accepting new patients
Conesus Lake Nursing Home, LLC Past Accepting new patients
1818 Como Park Boulevard Operating Company LLC Past Accepting new patients
Livingston County Past Accepting new patients
Ira Davenport Memorial Hospital, Inc. Past Accepting new patients
Schofield Residence Inc. Past Accepting new patients
4459 Bailey Avenue Operating Company LLC Past Accepting new patients
Orchard Park CCRC, Inc. PastSince Aug 1, 2022 Accepting new patients
200 Bassett Road Operating Company LLC Past Accepting new patients

Locations

7571 State Route 54
Ste A
Bath, NY 14810

40 La Riviere Dr
Ste 201
Buffalo, NY 14202
Phone (518) 335-5097

40 La Riviere Dr
Ste 201A
Buffalo, NY 14202
Phone 7168931010221

40 La Riviere Dr
Ste 140
Buffalo, NY 14202

4650 Southwestern Blvd
Hamburg, NY 14075
Phone (716) 648-2450

48 Colonial Dr
Horseheads, NY 14845
Phone (607) 739-0304

11 Murray Hill Dr
Mount Morris, NY 14510
Phone (585) 243-7200

98 Starr Farm Rd
Burlington, VT 05408
Phone (802) 658-6717

Interoperability endpoints

  • Direct secure messaging: mkueker@mobileprimarycare.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Schofield ResidenceKenmore, NY, CCN 335603 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 4, 2023
Jun 4, 2023
Livingston County Center for Nursing and RehabiliationMount Morris, NY, CCN 335562 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 3, 2023
Jul 3, 2023
Fox Run at Orchard ParkOrchard Park, NY, CCN 335854 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2022
Aug 1, 2002

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Livingston County

    dba Livingston County Center for Nursing and Rehabilitation

    • Skilled Nursing Facility
    • Mount Morris, NY
    • NPI 1376761478

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Orchard Park CCRC, Inc.

    dba Fox Run at Orchard Park

    • Skilled Nursing Facility
    • Orchard Park, NY
    • NPI 1639363153

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Schofield Residence Inc.

    dba Schofield Residence - SNF

    • Skilled Nursing Facility
    • Buffalo, NY
    • NPI 1871553537

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1013414986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LA RIVIERE DR STE 201",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024344",
            "telephone_number": "716-893-1010",
            "fax_number": "716-893-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Murray Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Morris",
            "state": "NY",
            "postal_code": "145101153",
            "country_code": "US",
            "telephone_number": "585-243-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUEKER",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.