Individual provider Active NPI

Gary Miller Proulx, M.D.

  • Radiation Oncology Physician
  • Sanborn, NY
National Provider Identifier
1194798165
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
206678-1 Issued in NY
Practice address
3850 Saunders Settlement Rd
Sanborn, NY 14132-9128
Phone
(716) 898-2800
Fax
(716) 898-2805
NPI assigned
Feb 9, 2006
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD419971 PA
Radiation Oncology Physician 2085R0001X 206678-1 NY Primary

Addresses

Primary practice location

3850 Saunders Settlement Rd
Sanborn, NY 14132-9128

Mailing address

3085 Harlem Rd Ste 350
Cheektowaga, NY 14225-2591
Phone (716) 844-5600

Other identifiers 6

IdentifierTypeStateIssuer
P00362286OtherNYRR MEDICARE PIN
0016314520003MedicaidPA
CC8362OtherNYRR MEDICARE GROUP
920007329OtherPARR MEDICARE PIN
01753942MedicaidNY
CC9269OtherPARR MEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040917000954 NY Practitioner - Radiation Oncology 2567430598 Reassigns benefits to 1 organization
I20080314000173 MA Practitioner - Radiation Oncology 2567430598 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206678-1NYMDRadiation Oncology Physician
MD419971PAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 16, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 16, 2023 Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

140 Lincoln Ave
Haverhill, MA 01830
Phone (978) 374-2000

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

70 East St
Methuen, MA 01844
Phone (978) 682-1906

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1194798165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 HARLEM RD STE 350",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252591",
            "telephone_number": "716-844-5600",
            "fax_number": "716-844-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SAUNDERS SETTLEMENT RD",
            "city": "SANBORN",
            "state": "NY",
            "postal_code": "141329128",
            "telephone_number": "716-898-2800",
            "fax_number": "716-898-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROULX",
        "first_name": "GARY",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD419971",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "206678-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00362286",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016314520003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC8362",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "920007329",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01753942",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanborn, NY

Sources for this page

Verify at the official NPI Registry.