NPIMap

Organization Active NPI

Great Lakes Anesthesiology, PC

  • Specialist
  • Buffalo, NY
National Provider Identifier
1306852181
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GREAT LAKES ANESTHESIOLOGY, PC
Practice address
818 Ellicott St
Buffalo, NY 14203-1021
Phone
(716) 323-6570
Fax
(716) 323-6658
NPI assigned
Jul 31, 2006
Last updated
Jan 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Megan Roemer
Title
Administrative Assistant
Phone
(716) 323-6570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

818 Ellicott St
Buffalo, NY 14203-1021

Mailing address

1001 Main St Ste K3502
Buffalo, NY 14203-1009
Phone (167) 323-6570

Other identifiers 1

IdentifierTypeStateIssuer
01868253MedicaidNY

Other names 1

  • CGF Anesthesiology Associates, PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040730000966 NY Part B Supplier - Clinic/Group Practice 7113997529 Receives reassigned benefits from 183 practitioners
Practice locations: Williamsville, NY; Olean, NY; Niagara Falls, NY; Cheektowaga, NY; Buffalo, NY
O20171129002800 PA Part B Supplier - Clinic/Group Practice 7113997529 Receives reassigned benefits from 35 practitioners
Practice locations: Warren, PA

National Provider Directory

National Provider Directory

Locations

1001 Main St
Ste K
Buffalo, NY 14203

1001 Main St
Ste K3502
Buffalo, NY 14203
Phone (716) 323-6576

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

Practitioners & affiliated clinicians

Practitioners 225

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 225

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1306852181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE K3502",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "167-323-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ELLICOTT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031021",
            "telephone_number": "716-323-6570",
            "fax_number": "716-323-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ANESTHESIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "ROEMER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "716-323-6570"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01868253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CGF Anesthesiology Associates, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CGF Anesthesiology Associates, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.