NPIMap

Organization Active NPI

Suburban Women's Healthcare PC

  • Obstetrics & Gynecology Physician
  • Tonawanda, NY
National Provider Identifier
1225030943
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SUBURBAN WOMEN'S HEALTHCARE PC
Practice address
4041 Delaware Ave
Ste 100
Tonawanda, NY 14150
Phone
(716) 876-5512
Fax
(716) 876-7342
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Loriann Fraas, MDNPI 1003855263
Title
Physician Owner President
Phone
(716) 876-5512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

4041 Delaware Ave
Ste 100
Tonawanda, NY 14150

Mailing address

4041 Delaware Ave
Ste 100
Tonawanda, NY 14150
Phone (716) 876-5512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001189 NY Part B Supplier - Clinic/Group Practice 7113917527 Receives reassigned benefits from 7 practitioners
Practice locations: Amherst, NY

National Provider Directory

National Provider Directory

Locations

3620 Sheridan Dr
#200
Buffalo, NY 14226
Phone (716) 876-5512

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225030943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 DELAWARE AVE",
            "address_2": "STE 100",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "14150",
            "telephone_number": "716-876-5512",
            "fax_number": "716-876-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 DELAWARE AVE",
            "address_2": "STE 100",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "14150",
            "telephone_number": "716-876-5512",
            "fax_number": "716-876-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN WOMEN'S HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRAAS",
        "authorized_official_first_name": "LORIANN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER PRESIDENT",
        "authorized_official_telephone_number": "716-876-5512",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.