NPIMap

Organization Active NPI

The Chautauqua Center, Inc

  • Gynecology Physician
  • Elmira, NY
National Provider Identifier
1326817693
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
THE CHAUTAUQUA CENTER, INC
Practice address
1005 Walnut St
Elmira, NY 14901-1007
Phone
(716) 363-6050
NPI assigned
Dec 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Amy Walters
Title
Cfo
Phone
(716) 673-5956

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X Primary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1005 Walnut St
Elmira, NY 14901-1007

Mailing address

75 E 3Rd St
Dunkirk, NY 14048-2239
Phone (716) 363-6050

Other practice location 1

75 E 3rd St
Dunkirk, NY 14048-2239
Phone (716) 363-6050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130805000454 NY Part B Supplier - Clinic/Group Practice 7214178326 Receives reassigned benefits from 72 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jamestown, NY; Olean, NY; Mayville, NY; Gowanda, NY; Forestville, NY; Elmira, NY; Dunkirk, NY
O20251030002898 NY Part A Provider - Federally Qualified Health Center (FQHC) 7214178326 Practice locations: Elmira, NY

Federally qualified health center certification: CCN 571924

Legal name
THE CHAUTAUQUA CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 28, 2025
Last certification
Oct 28, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1005 Walnut St
Elmira, NY 14901-1007

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0720525Chautauqua Center Elmira, the1005 Walnut St, Elmira, NY 14901Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
The Chautauqua Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15 S Main St
Ste 220
Jamestown, NY 14701
Phone (716) 484-4334

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22211/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Clark Poppleton Individual Corporate DirectorBoard Member Jun 1, 2014
Michael C Pease Individual Corporate OfficerCeo Aug 10, 2012
W-2 Managing EmployeeCeo Aug 10, 2012 100%
Operational/Managerial ControlCeo Aug 10, 2012 100%
Eloy Bautista Individual Corporate DirectorBod Secretary Jun 1, 2014
Laura Koepke Individual Corporate DirectorBod Member Jun 1, 2019
Ellen Luczkowiak Individual Corporate DirectorBod Chair Jun 1, 2019
Amy E. Walters Individual Corporate OfficerCfo Feb 7, 2017 100%
W-2 Managing EmployeeCfo Feb 7, 2017 100%
Operational/Managerial ControlCfo Feb 7, 2017 100%
Jarrod Johnson Individual Corporate DirectorBoard Treasurer Aug 1, 2013
Rita Canfora Individual Corporate DirectorBod Member Jun 1, 2014
Elizabeth Kidder Individual Corporate OfficerCmo Aug 1, 2025
W-2 Managing EmployeeMD; Aug 1, 2025 100%
Operational/Managerial ControlCmo Aug 1, 2025 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Elizabeth Kidder, MD
    • Internal Medicine Physician
    • Jamestown, NY
    • NPI 1407276587

    Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1326817693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482239",
            "telephone_number": "716-363-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011007",
            "telephone_number": "716-363-6050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "NY",
            "postal_code": "140482239",
            "country_code": "US",
            "telephone_number": "716-363-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CHAUTAUQUA CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-27",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "716-673-5956"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.