Individual provider Active NPI

Prama Luther, M.D.

  • Family Medicine Physician
  • Cheektowaga, NY
National Provider Identifier
1164524708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
181906 Issued in NY
Practice address
2671 Harlem Rd
Cheektowaga, NY 14225-4019
Phone
(716) 895-1410
Fax
(716) 895-1829
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 181906 NY Primary

Addresses

Primary practice location

2671 Harlem Rd
Cheektowaga, NY 14225-4019

Mailing address

200 Halston Pkwy
East Amherst, NY 14051-1856
Phone (716) 688-8052

Other identifiers 4

IdentifierTypeStateIssuer
01830322MedicaidNY
000523457002OtherBLUE SHIELD
00010107401OtherUNIVERA
6409973OtherINDEPEDENT HEALTH

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
I20041103001045 NY Practitioner - Pathology 5597727222 Practice locations: Cheektowaga, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181906NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164524708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HALSTON PKWY",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511856",
            "telephone_number": "716-688-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254019",
            "telephone_number": "716-895-1410",
            "fax_number": "716-895-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "PRAMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "181906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01830322",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000523457002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010107401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPEDENT HEALTH",
            "identifier": "6409973",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.