Stanley Walter Ambis, MD

Individual provider Active NPI Family Medicine Physician · Le Roy, NY

NPI 1285736066 · NPPES record last updated Jan 21, 2016

Key facts

NPI
1285736066
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
A206094 (NY)
Practice address
3 Tountas Ave
Suite 4
Le Roy, NY 14482-1368
Phone
(585) 768-6530
Fax
(585) 768-4593
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110405000099 NY Practitioner - Family Practice 6305020017 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A206094NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Memorial Medical Center Current
since Jan 1, 2000
Accepting new patients
United Memorial Medical Center Family Medicine Current
since Jan 1, 2000
Accepting new patients

Locations

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

127 North St
Batavia, NY 14020
Phone (585) 267-7510

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

3 Tountas Ave
Ste 4
Le Roy, NY 14482
Phone (585) 768-4670

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A206094 NY
Family Medicine Physician 207Q00000X A206094 NY Yes

Addresses

Primary practice location

3 Tountas Ave
Suite 4
Le Roy, NY 14482-1368

Mailing address

3 Tountas Ave
Suite 4
Le Roy, NY 14482-1368
Phone (585) 768-6530

Other identifiers

IdentifierTypeStateIssuer
103474BFOtherPREFERRED CARE
3391353OtherIHA
P010206094OtherBCBS OF ROCHESTER
103474GBOtherPREFERRED CARE ACUPUNCURE
00025084401OtherUNIVERA
5998829OtherGHI
5724679OtherAETNA
080144934OtherRAILROAD
CC1766OtherPIN
040426004274OtherFIDELIS
1826038OtherFIRST HEALTH
005259021OtherBCBS OF WNY
G36839OtherUPIN

Other providers in Le Roy, NY

All providers in Le Roy, NY · Family Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.