NPIMap

Individual provider Active NPI

Elvin D Witmer, MD

  • Family Medicine Physician
  • Depew, NY
National Provider Identifier
1356384382
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2104211 Issued in NY
Practice address
571 Terrace Blvd
Depew, NY 14043-3610
Phone
(716) 683-4196
Fax
(716) 646-0763
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2104211 NY Primary

Addresses

Primary practice location

571 Terrace Blvd
Depew, NY 14043-3610

Mailing address

571 Terrace Blvd
Depew, NY 14043-3610
Phone (716) 683-4196

Other identifiers 5

IdentifierTypeStateIssuer
01886039MedicaidNY
080134287OtherNYRAILROAD MEDICARE
000525241003OtherNYBLUE SHIELD WNY
00020022602OtherNYUNIVERA HEALTHCARE
0191742OtherNYINDEPENDENT HEALTH ASSOC

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
I20070703000380 NY Practitioner - Family Practice 6901906064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Primary Care Associates, LLPGroup PAC ID 9931013703, 13 clinicians

Practice addresses (Care Compare)

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2104211NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Primary Care Associates LLP Family Medicine CurrentSince Feb 15, 2020 Accepting new patients
Cogent Medical Care PC Family Medicine CurrentSince Sep 4, 2019 Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients
Ronald Palazzo, M.D., P.C. Family Medicine Past Accepting new patients

Locations

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

571 Terrace Blvd
Depew, NY 14043
Phone (716) 683-4196

4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

Interoperability endpoints

  • Direct secure messaging: ewitmer@lakeshorepca.medentdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1356384382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 TERRACE BLVD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140433610",
            "telephone_number": "716-683-4196",
            "fax_number": "716-646-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 TERRACE BLVD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140433610",
            "telephone_number": "716-683-4196",
            "fax_number": "716-646-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMER",
        "first_name": "ELVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-02-27",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "2104211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01886039",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080134287",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD WNY",
            "identifier": "000525241003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA HEALTHCARE",
            "identifier": "00020022602",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH ASSOC",
            "identifier": "0191742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.