Ontario Lakeside Medical Associates

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1828341 Issued in NY

Legal business name

ONTARIO LAKESIDE MEDICAL ASSOCIATES

Practice address

90 W Utica St
Oswego, NY 13126

Phone

(315) 342-8552

Fax

(315) 342-8572

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carlos O Dator, MD

Title

Physician

Phone

(315) 342-8552

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen S Bautista Dator, MD

  • Internal Medicine Physician
  • Oswego, NY
  • NPI 1346267291
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1184645368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 W UTICA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263048",
            "telephone_number": "315-342-8552",
            "fax_number": "315-342-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W UTICA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-342-8552",
            "fax_number": "315-342-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONTARIO LAKESIDE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "DATOR",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "315-342-8552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1828341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gideon Ikechukw Ochiabuto
• Kelley Elaine Ohora
• Catherine Mary Okoniewski, FNP
• Alicia Marie Olsen
• Dinah M. Olson, P.A.
• Ontario Medical Practice PC
• Amy J Orr, LMSW
• Carolyn Ann Ortolano
• Oswego Cardiac Wellness Center LLC
• Oswego City School District

• Internal Medicine Physician in Oswego, NY
• Providers in Oswego, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.