Active NPI
Eugene James Kalmuk Jr., MD
- Internal Medicine Physician
- Cheektowaga, NY
National Provider Identifier
1114912367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 1613451
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00891832 | Medicaid | NY | |
| 000510526007 | Other | NY | BCBS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1613451 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current | Accepting new patients | |
| Trinity Medical Wny PC | Past | 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.
-
- Vascular Surgery Physician
- Buffalo, NY
- NPI 1205468055
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.