Individual provider Active NPI

Paul Michael Chlosta, D.M.D.

  • General Practice Dentistry
  • Hamburg, NY
National Provider Identifier
1649280447
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39357 Issued in NY
Practice address
3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone
(716) 648-6156
Fax
(716) 648-6156
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39357 NY Primary

Addresses

Primary practice location

3040 Amsdell Rd
Hamburg, NY 14075-5835

Mailing address

3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone (716) 648-6156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151222002222 NY Order and Referring Only - DentistPractitioner - Dentist 4880995554
I20160201002502 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880995554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39357NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649280447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-648-6156",
            "fax_number": "716-648-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-648-6156",
            "fax_number": "716-648-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHLOSTA",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "39357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.