Individual provider Active NPI

Alan Vlieg, PA

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1245860840
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3041 Orchard Park Rd
Ste C
Orchard Park, NY 14127-1238
Phone
(716) 674-3104
Fax
(716) 674-0666
NPI assigned
Jan 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3041 Orchard Park Rd
Ste C
Orchard Park, NY 14127-1238

Mailing address

3041 Orchard Park Rd
Ste C
Orchard Park, NY 14127-1238
Phone (716) 674-3104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423002979 NY Practitioner - Physician Assistant 7315377884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

2150 Wehrle Dr
Suite 100
Williamsville, NY 14221-7099
Phone (716) 881-9077

Hospital & facility affiliations

  • Mount St. Mary'S Hospital & Health Center Hospital, Lewiston, NY, CCN 330188
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saif Soniwala,M.D.,PC Current Accepting new patients

Locations

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

Interoperability endpoints

  • Direct secure messaging: avlieg@breastcarewny.medentdirect.com

Organizations & group practices 2

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

Hospital & facility affiliations 7

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": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1245860840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 ORCHARD PARK RD",
            "address_2": "STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271238",
            "telephone_number": "716-674-3104",
            "fax_number": "716-674-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 ORCHARD PARK RD",
            "address_2": "STE C",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271238",
            "telephone_number": "716-674-3104",
            "fax_number": "716-674-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLIEG",
        "first_name": "ALAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2024-08-29",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.