NPIMap

Organization Active NPI

BLT Medical Group, LLP

  • Family Medicine Physician
  • West Seneca, NY
National Provider Identifier
1386671816
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLT MEDICAL GROUP, LLP
Practice address
1026 Union Rd
West Seneca, NY 14224-3445
Phone
(716) 712-1030
NPI assigned
Jun 28, 2006
Last updated
Jan 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Authorized official

Name
Leroy W McCune, MDNPI 1497741391
Title
President
Phone
(716) 651-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1026 Union Rd
West Seneca, NY 14224-3445

Mailing address

3719 Union Rd
Suite 218
Cheektowaga, NY 14225-4249

Other identifiers 1

IdentifierTypeStateIssuer
02782070MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060929000384 NY Part B Supplier - Clinic/Group Practice 5496750291 Receives reassigned benefits from 26 practitioners
Practice locations: Jamestown, NY; Lancaster, NY; Medina, NY; Newfane, NY; North Tonawanda, NY; Orchard Park, NY; Salamanca, NY; Springville, NY…

National Provider Directory

National Provider Directory

Locations

5959 Broadway St
Lancaster, NY 14086
Phone (716) 684-3000

1026 Union Rd
West Seneca, NY 14224
Phone (716) 712-0851

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1386671816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 UNION RD",
            "address_2": "SUITE 218",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLT MEDICAL GROUP, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "MCCUNE",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-651-0911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02782070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.