Organization Active NPI

Legacy Gynecology PLLC

  • Gynecology Physician
  • Amherst, NY
National Provider Identifier
1598370975
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
LEGACY GYNECOLOGY PLLC
Practice address
136 Maple Rd
Amherst, NY 14221-2922
Phone
(716) 815-2400
NPI assigned
Sep 11, 2020
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Kristen Smyers, MDNPI 1063652972
Title
MD/Owner
Phone
(716) 815-2400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

136 Maple Rd
Amherst, NY 14221-2922

Mailing address

99 S Rockingham Way
Amherst, NY 14228-3723
Phone (716) 815-2400

Other identifiers 1

IdentifierTypeStateIssuer
03351159MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2196173Legacy Gynecology PLLC136 Maple Road, Williamsville, NY 14221Certificate of waiverOct 14, 2026

National Provider Directory

National Provider Directory

Locations

136 Maple Rd
Williamsville, NY 14221
Phone (716) 632-8124

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1598370975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 S ROCKINGHAM WAY",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283723",
            "telephone_number": "716-815-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MAPLE RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142212922",
            "telephone_number": "716-815-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY GYNECOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "SMYERS",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "716-815-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03351159",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.