Individual provider Active NPI

Guy M Whalen, M.D.

  • Internal Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1629052667
Registry record updated Jul 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
178512 Issued in NY
Practice address
3675 Southwestern Blvd
Orchard Park, NY 14127-1732
Phone
(716) 972-0279
Fax
(716) 972-0273
NPI assigned
Dec 2, 2005
Last updated
Jul 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 178512 NY Primary

Addresses

Primary practice location

3675 Southwestern Blvd
Orchard Park, NY 14127-1732

Mailing address

3675 Southwestern Blvd
Orchard Park, NY 14127-1732
Phone (716) 972-0279

Other identifiers 5

IdentifierTypeStateIssuer
0409951OtherNYIHA
000510800004OtherNYBC/BS
434280OtherNYWELLCARE
01140472MedicaidNY
00010188203OtherNYUNIVERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406332800000",
    "number": "1629052667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271732",
            "telephone_number": "716-972-0279",
            "fax_number": "716-972-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271732",
            "telephone_number": "716-972-0279",
            "fax_number": "716-972-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "GUY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2014-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "178512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "0409951",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000510800004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "434280",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01140472",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010188203",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.