NPIMap

Individual provider Active NPI

Benjamin B Luong, M.D.

  • Urology Physician
  • Jamestown, NY
National Provider Identifier
1336439744
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
284342 Issued in NY
Practice address
117 Foote Ave
Jamestown, NY 14701-6947
Phone
(716) 338-9200
Fax
(716) 338-9250
NPI assigned
Apr 19, 2011
Last updated
Dec 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 284342 NY Primary

Addresses

Primary practice location

117 Foote Ave
Jamestown, NY 14701-6947

Mailing address

3085 Harlem Rd Ste 350
Cheektowaga, NY 14225-2591
Phone (716) 844-5600

Other identifiers 1

IdentifierTypeStateIssuer
04769348MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622000493 NY Practitioner - Urology 4183915473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Southern Illinois University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Physician PCGroup PAC ID 9133434269, 65 clinicians

Practice addresses (Care Compare)

117 Foote Ave
Suite 100
Jamestown, NY 14701-6947
Phone (716) 338-9200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.58 of 100Reported as group
Quality
39.81
Promoting interoperability
88
Improvement activities
40
Cost
83.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection21
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physician, PC Urology CurrentSince Aug 1, 2017 Accepting new patients
Great Lakes Physician, PC Urology CurrentSince Aug 1, 2017 Accepting new patients

Locations

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225
Phone (716) 844-5000

504 Central Ave
Dunkirk, NY 14048
Phone (716) 366-9008

117 Foote Ave
Ste 100
Jamestown, NY 14701
Phone (716) 338-9200

117 Foote Ave
#100
Jamestown, NY 14701
Phone (716) 338-9200

117 Foote Ave
Jamestown, NY 14701
Phone (716) 338-9200

Interoperability endpoints

  • Direct secure messaging: drluong@qualitycare.medentdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1336439744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 HARLEM RD STE 350",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252591",
            "telephone_number": "716-844-5600",
            "fax_number": "716-844-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016947",
            "telephone_number": "716-338-9200",
            "fax_number": "716-338-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "BENJAMIN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "284342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04769348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.