Individual provider Active NPI

Mohamad Karim Kechli

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1154980266
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P11348 Issued in NY
Practice address
1001 Main St Ste K-3502
Buffalo, NY 14203-1009
Phone
(716) 323-6659
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X P11348 NY Primary

Addresses

Primary practice location

1001 Main St Ste K-3502
Buffalo, NY 14203-1009

Mailing address

1001 Main St Ste K-3502
Buffalo, NY 14203-1009
Phone (716) 323-6659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200714001047 NY Practitioner - Anesthesiology 3476976135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians

Practice addresses (Care Compare)

515 Main St
Olean, NY 14760-1513
Phone (716) 323-6570

Hospital & facility affiliations

  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Olean General Hospital Hospital, Olean, NY, CCN 330103
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P11348NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesiology, PC CurrentSince Jul 1, 2020 Accepting new patients

Locations

1001 Main St
Ste K3502
Buffalo, NY 14203
Phone (716) 323-6576

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

515 Main St
Olean, NY 14760
Phone (716) 373-2600

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1154980266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE K-3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE K-3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECHLI",
        "first_name": "MOHAMAD",
        "middle_name": "KARIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "P11348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.