NPIMap

Individual provider Active NPI

Matthew Radel

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1649621624
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019756-1 Issued in NY
Practice address
500 Sterling Dr
Orchard Park, NY 14127-1573
Phone
(716) 677-2273
Fax
(716) 677-2256
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019756-1 NY Primary

Addresses

Primary practice location

500 Sterling Dr
Orchard Park, NY 14127-1573

Mailing address

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225-2591
Phone (716) 844-5600

Other identifiers 1

IdentifierTypeStateIssuer
04540429MedicaidNY

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
I20160927000117 NY Practitioner - Physician Assistant 2567759194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physician PCGroup PAC ID 9133434269, 65 clinicians

Practice addresses (Care Compare)

3085 Harlem Rd
Cheektowaga, NY 14225-2591
Phone (716) 844-5000

500 Sterling Dr
Orchard Park, NY 14127-1573
Phone (716) 677-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.58 of 100Reported as group
Quality
39.81
Promoting interoperability
88
Improvement activities
40
Cost
83.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
019756-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physician, PC CurrentSince Aug 1, 2016 Accepting new patients

Locations

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225
Phone (716) 844-5000

7060 Erie Rd
Derby, NY 14047
Phone (716) 677-2273

3040 Amsdell Rd
Hamburg, NY 14075
Phone (716) 646-6700

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

500 Sterling Dr
Orchard Park, NY 14127
Phone (716) 677-2273

408 N Main St
Warsaw, NY 14569
Phone (585) 786-2090

Interoperability endpoints

  • Direct secure messaging: mradel@qualitycare.medentdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1649621624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 HARLEM RD",
            "address_2": "STE 350",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252591",
            "telephone_number": "716-844-5600",
            "fax_number": "716-844-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STERLING DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271573",
            "telephone_number": "716-677-2273",
            "fax_number": "716-677-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEL",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019756-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04540429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.