Individual provider Active NPI

Lyndsay Ann Gutierrez-Panchal, MD

  • Surgery Physician
  • Williamsville, NY
National Provider Identifier
1235360629
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
257422 Issued in NY
Practice address
180 Park Club LN
Williamsville, NY 14221-5263
Phone
(716) 332-6834
Fax
(716) 332-6856
NPI assigned
Aug 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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 257422 NY Primary

Addresses

Primary practice location

180 Park Club LN
Williamsville, NY 14221-5263

Mailing address

180 Park Club LN
Williamsville, NY 14221-5263
Phone (716) 332-6834

Other identifiers 1

IdentifierTypeStateIssuer
03237625MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1235360629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215263",
            "telephone_number": "716-332-6834",
            "fax_number": "716-332-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215263",
            "telephone_number": "716-332-6834",
            "fax_number": "716-332-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ-PANCHAL",
        "first_name": "LYNDSAY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "257422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03237625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.