NPIMap

Organization Active NPI

Kenmore Mercy Hospital

Doing business as Kenmore Mercy Professional Services

  • Pulmonary Disease Physician
  • Kenmore, NY
National Provider Identifier
1659909752
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
KENMORE MERCY HOSPITAL
Doing business as
Kenmore Mercy Professional Services
Practice address
2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone
(716) 447-6100
NPI assigned
Apr 1, 2020
Last updated
Apr 1, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
KENMORE MERCY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
David P Macholz
Title
Authorized Official
Phone
(716) 601-3690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

2950 Elmwood Ave
Kenmore, NY 14217-1304

Mailing address

144 Genesee St FL 3
Buffalo, NY 14203-1560

Other names 1

  • Kenmore Mercy Professional Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319000138 NY Part B Supplier - Clinic/Group Practice 7517870462 Receives reassigned benefits from 352 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kenmore, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Catholic Health System

Locations

2780 Delaware Ave
Kenmore, NY 14217
Phone (716) 633-6363

300 Two Mile Creek Rd
Tonawanda, NY 14150
Phone (716) 447-6450

Practitioners & affiliated clinicians

Practitioners 257

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.

View all 257

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1659909752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 GENESEE ST FL 3",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-447-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMORE MERCY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENMORE MERCY HOSPITAL",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "MACHOLZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "716-601-3690"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenmore Mercy Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.