NPIMap

Organization Active NPI

Eastern Niagara Hospital, Inc

  • General Acute Care Hospital
  • Lockport, NY
National Provider Identifier
1063400539
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
3101000H Issued in NY
Legal business name
EASTERN NIAGARA HOSPITAL, INC
Practice address
521 East Ave
Lockport, NY 14094-3201
Phone
(716) 514-5501
Fax
(716) 514-5549
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Mr. Michael Francis Ickowski, MBA, CPA
Title
Chief Financial Officer
Phone
(716) 514-5501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
General Acute Care Hospital 282N00000X 3101000H NY Primary

Addresses

Primary practice location

521 East Ave
Lockport, NY 14094-3201

Mailing address

521 East Ave
Lockport, NY 14094-3201
Phone (716) 514-5501

Other identifiers 6

IdentifierTypeStateIssuer
00011412701OtherNYUNIVERA BILLING #
000000031000OtherNYBCBS BILLING #
00354389MedicaidNY
000000030000OtherNYBCBS BILLING #
13OtherNYIHA BILLING #
89OtherNYIHA BILLING #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1063400539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943201",
            "telephone_number": "716-514-5501",
            "fax_number": "716-514-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943201",
            "telephone_number": "716-514-5501",
            "fax_number": "716-514-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NIAGARA HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "ICKOWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "716-514-5501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "3101000H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA BILLING #",
            "identifier": "00011412701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BILLING #",
            "identifier": "000000031000",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354389",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BILLING #",
            "identifier": "000000030000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA BILLING #",
            "identifier": "13",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA BILLING #",
            "identifier": "89",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.