NPIMap

Individual provider Active NPI

Michael S. Conjalka, M.D.

  • Hematology & Oncology Physician
  • Elmira, NY
National Provider Identifier
1285646125
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
134887 Issued in NY
Practice address
600 Roe Avenue
Falck Cancer Center
Elmira, NY 14905-1629
Phone
(607) 737-8165
Fax
(607) 737-8175
NPI assigned
Aug 12, 2006
Last updated
Feb 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 134887 NY Primary

Addresses

Primary practice location

600 Roe Avenue
Falck Cancer Center
Elmira, NY 14905-1629

Mailing address

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-8165

Other practice location 1

4950 State Highway 30
Cancer Medicine Center
Amsterdam, NY 12010-7520
Phone (518) 770-7557

Other identifiers 2

IdentifierTypeStateIssuer
00783404MedicaidNY
1024861160001MedicaidPA

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
I20080307000232 NY Practitioner - Medical Oncology 7911912241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Northwestern University Feinberg Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Mary's HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

4950 State Hwy 30
Amsterdam, NY 12010-7520
Phone (518) 770-7557

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Healthcare Past Accepting new patients
William Noyes, MD PC Hematology & Oncology PastSince Sep 1, 2004 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Meadville Medical Center Hematology & Oncology PastSince Aug 3, 2010 Accepting new patients
Arnot Medical Services PLLC Past Accepting new patients
Meadville Medical Center Past Accepting new patients
St. Vincent Hospice - Anderson LLC Past Accepting new patients

Organizations & group practices 8

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 5

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1285646125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051629",
            "telephone_number": "607-737-8165",
            "fax_number": "607-737-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVENUE",
            "address_2": "FALCK CANCER CENTER",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051629",
            "telephone_number": "607-737-8165",
            "fax_number": "607-737-8175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4950 State Highway 30",
            "address_2": "Cancer Medicine Center",
            "address_purpose": "LOCATION",
            "city": "Amsterdam",
            "state": "NY",
            "postal_code": "120107520",
            "country_code": "US",
            "telephone_number": "518-770-7557",
            "fax_number": "518-770-7558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONJALKA",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "134887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783404",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024861160001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.