Charles J Fetterman MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

214954-1 Issued in NY

Legal business name

CHARLES J FETTERMAN MD PC

Practice address

70 Professional Pkwy
Lockport, NY 14094-5366

Phone

(716) 434-7505

Fax

(716) 439-9084

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia A Weinheimer

Title

Office Manager

Phone

(716) 434-7505

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Interoperability endpoints

• Direct secure messaging: cfetterman@fetterman.intellechartdirect.net
• Direct secure messaging: abuccilli@fetterman.intellechartdirect.net

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea M Buccilli, MD

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1770724635
  Medicare reassignment Care Compare group NPD
• Charles J Fetterman, MD

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1922038785
  Medicare reassignment Care Compare group NPD
• John W Crofts, MD

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1497770580
  NPD (past)
• Vivian Kudgus Fasula, M.D.

  • Ophthalmology Physician
  • Lockport, NY
  • NPI 1073570396
  NPD (past)
• Shannon Lyn Schug, O.D.

  • Optometrist
  • Buffalo, NY
  • NPI 1144420142
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1316004013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PKWY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PROFESSIONAL PKWY",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945366",
            "telephone_number": "716-434-7505",
            "fax_number": "716-439-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J FETTERMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "WEINHEIMER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "716-434-7505",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "148889-1",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "214954-1",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "251762-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CCS Billing, LLC
• CCS Oncology, P.C.
• Deborah Jane Centofanti, LMT
• Karen Anne Certo, RPH
• Shuyu Chang, ATC, PTA
• Cheryl a. Sand
• D. Theodore Chojecki
• Jessica Christ
• Christopher E. Beney, MD, PC
• Breanna Ciccarelli, LMSW

• Ophthalmology Physician in Lockport, NY
• Providers in Lockport, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.