Lord Admoz, CASAC - T

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

20688 Issued in NY

Practice address

6301 Inducon Dr E
Sanborn, NY 14132-9014

Phone

(716) 731-2030

Fax

(716) 731-3010

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/78f4cdd4-55a7-4d47-b25a-4d044d550506/

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.

• Horizon Health Services

  • Substance Abuse Rehabilitation Facility
  • Sanborn, NY
  • NPI 1326344409
  NPD (past)
• Horizon Village

  • Substance Abuse Rehabilitation Facility
  • Sanborn, NY
  • NPI 1902063522
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285774885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OAKGROVE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142081006",
            "telephone_number": "716-885-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 INDUCON DR E",
            "city": "SANBORN",
            "state": "NY",
            "postal_code": "141329014",
            "telephone_number": "716-731-2030",
            "fax_number": "716-731-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADMOZ",
        "first_name": "LORD",
        "credential": "CASAC - T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "20688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC - T",
            "identifier": "20688",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basharat Ali, M.D.
• Elaine Ausman
• Sheryl Lynn Bates, PHYSICAL THERAPIST
• Kirsten Bearfield
• Dina Blyashuk

• Substance Abuse Rehabilitation Facility in Sanborn, NY
• Providers in Sanborn, NY by specialty
• Substance Abuse Rehabilitation Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.