Individual provider Active NPI

Eugene James Kalmuk Jr., MD

  • Internal Medicine Physician
  • Cheektowaga, NY
National Provider Identifier
1114912367
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1613451 Issued in NY
Practice address
2625 Harlem Rd
Suite 180
Cheektowaga, NY 14225-4031
Phone
(716) 893-4797
Fax
(716) 893-1697
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1613451 NY Primary

Addresses

Primary practice location

2625 Harlem Rd
Suite 180
Cheektowaga, NY 14225-4031

Mailing address

2625 Harlem Rd
Suite 180
Cheektowaga, NY 14225-4031
Phone (716) 893-4797

Other identifiers 2

IdentifierTypeStateIssuer
00891832MedicaidNY
000510526007OtherNYBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Buffalo

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108000941 GA Practitioner - Internal Medicine 8729173034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1613451NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Dec 3, 2023 Accepting new patients
Trinity Medical Wny PC PastSince Oct 31, 2011 Accepting new patients

Locations

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1114912367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 HARLEM RD",
            "address_2": "SUITE 180",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254031",
            "telephone_number": "716-893-4797",
            "fax_number": "716-893-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 HARLEM RD",
            "address_2": "SUITE 180",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254031",
            "telephone_number": "716-893-4797",
            "fax_number": "716-893-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALMUK",
        "first_name": "EUGENE",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1613451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00891832",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000510526007",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Buffalo",
            "affiliation": "N",
            "address_1": "2625 Harlem Rd",
            "address_2": "Suite 180",
            "city": "Cheektowaga",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142254031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.