NPIMap

Individual provider Active NPI

Kevin Lyon, DO

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1538629605
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
316609 Issued in NY
Practice address
85 High St
Buffalo, NY 14203-1194
Phone
(716) 656-4479
Fax
(716) 250-5986
NPI assigned
Mar 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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
Family Medicine Physician 207Q00000X 316609 NY Primary

Addresses

Primary practice location

85 High St
Buffalo, NY 14203-1194

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

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
I20220712002318 NY Practitioner - Family Practice 1759618192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Practice addresses (Care Compare)

85 High St
Buffalo, NY 14203-1149
Phone (716) 630-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
316609NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Group, P.C. Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Jul 1, 2022 Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

Interoperability endpoints

  • Direct secure messaging: klyon12887@direct.buffalomedicalgroup.com

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 11

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": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1538629605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031194",
            "telephone_number": "716-656-4479",
            "fax_number": "716-250-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "316609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.