NPIMap

Individual provider Active NPI

Robert Wayne Hodge, M.D.

  • Surgery Physician
  • Lockport, NY
National Provider Identifier
1215989173
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
184736-7 Issued in KY
Practice address
160 East Ave
Lockport, NY 14094-3835
Phone
(716) 434-6141
Fax
(716) 434-0594
NPI assigned
May 17, 2006
Last updated
May 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 184736-7 KY Primary

Addresses

Primary practice location

160 East Ave
Lockport, NY 14094-3835

Mailing address

160 East Ave
Lockport, NY 14094-3835
Phone (716) 434-6141

Other identifiers 1

IdentifierTypeStateIssuer
01449485MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080222000424 NY Practitioner - General Surgery 6800970344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Surgical Associates, P.C.Group PAC ID 4486738929, 5 clinicians
Orleans Community HealthGroup PAC ID 7315857018, 20 clinicians

Practice addresses (Care Compare)

160 E Ave
Lockport, NY 14094-3835
Phone (716) 434-6141

200 Ohio St
Medina, NY 14103-1063
Phone (716) 798-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy97
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)14
Upper gastrointestinal (GI) endoscopy for acid reflux27
Varicose vein removal1-10
Melanoma (skin cancer) excision1-10
Removal of tissue13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184736-7KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orleans Community Health CurrentSince Dec 1, 2023 Accepting new patients
Orleans Community Health CurrentSince Dec 1, 2023 Accepting new patients
Great Lakes Surgical Associates, P.C. Surgery CurrentSince Feb 15, 2008 Accepting new patients
Kenmore Mercy Hospital Past Accepting new patients

Locations

14789 State Route 31
Albion, NY 14411
Phone (585) 589-2273

15 Elizabeth Dr
Lockport, NY 14094
Phone (716) 434-6141

160 East Ave
Lockport, NY 14094
Phone (716) 434-6141

200 Ohio St
Medina, NY 14103
Phone (585) 798-2000

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1215989173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943835",
            "telephone_number": "716-434-6141",
            "fax_number": "716-434-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943835",
            "telephone_number": "716-434-6141",
            "fax_number": "716-434-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "ROBERT",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "184736-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01449485",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.