Individual provider Active NPI

Kevin R. Nowak, MD

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1477813913
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
283924-1 Issued in NY
Practice address
515 Abbott Road
Buffalo, NY 14220-1114
Phone
(716) 826-6628
Fax
(716) 828-3448
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 283924-1 NY Primary

Addresses

Primary practice location

515 Abbott Road
Buffalo, NY 14220-1114

Mailing address

515 Abbott Road
Suite 410
Buffalo, NY 14220-1114
Phone (716) 826-6628

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
I20160721002577 NY Practitioner - Anesthesiology 5092008458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians
Anesthesiology Medical Consultants, PLLCGroup PAC ID 0648179093, 25 clinicians

Practice addresses (Care Compare)

3095 Harlem Rd
Cheektowaga, NY 14225-2500
Phone (716) 323-6570

550 Orchard Park Rd
BLDG B
West Seneca, NY 14224-2646
Phone (716) 677-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
80.2
Improvement activities
40
Cost
72.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
283924-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Medical Consultants, PLLC Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Great Lakes Anesthesiology, PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

338 Harris Hill Rd
Ste 207
Williamsville, NY 14221

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.

Hospital & facility affiliations 4

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1477813913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 ABBOTT ROAD",
            "address_2": "SUITE 410",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201114",
            "telephone_number": "716-826-6628",
            "fax_number": "716-828-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 ABBOTT ROAD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201114",
            "telephone_number": "716-826-6628",
            "fax_number": "716-828-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "KEVIN",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "283924-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.