Individual provider Active NPI

George Constantine Kalonaros, MD

  • Neurology Physician
  • Kenmore, NY
National Provider Identifier
1396703583
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
155226 Issued in NY
Practice address
2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone
(716) 447-7260
Fax
(716) 447-7263
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 155226 NY Primary

Addresses

Primary practice location

2950 Elmwood Ave
Kenmore, NY 14217-1304

Mailing address

2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone (716) 447-7260

Other identifiers 5

IdentifierTypeStateIssuer
01122774MedicaidNY
0509854OtherNYINDEPENDENT HEALTH
130011312OtherNYRAILROAD MEDICARE
00010086901OtherNYUNIVERA
000529289001OtherNYBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071219000283 NY Practitioner - Neurology 0042300774 Practice locations: N Tonawanda, NY; Niagara Falls, NY; Kenmore, NY; Hamburg, NY; Buffalo, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155226NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
George C Kalonaros MD Neurology PastSince Jan 1, 1990 Accepting new patients
Donald P. Copley MD PC PastSince Dec 15, 2007 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1396703583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-447-7260",
            "fax_number": "716-447-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-447-7260",
            "fax_number": "716-447-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALONAROS",
        "first_name": "GEORGE",
        "middle_name": "CONSTANTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "155226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01122774",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0509854",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130011312",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010086901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000529289001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

Verify at the official NPI Registry.