NPIMap

Organization Active NPI

Kenmore Mercy Hospital

  • 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
Practice address
2950 Elmwood Ave
Kenmore, NY 14217-1304
Phone
(716) 447-6100
NPI assigned
Apr 1, 2020
Organization subpart
Yes
Parent organization
KENMORE MERCY HOSPITALAs reported in NPPES

Authorized official

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

Other NPIs on the same Medicare enrollment 2

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

Practitioners 333

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 333

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

National Provider Directory

National Provider Directory
Part of
Ellicott Creek Medical

Locations

500 Ontario St
Buffalo, NY 14207
Phone (716) 447-6650

1495 Military Rd
Kenmore, NY 14217
Phone (716) 447-6037

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

NPPES NPI Registry

Primary practice location

2950 Elmwood Ave
Kenmore, NY 14217-1304

Mailing address

144 Genesee St FL 3
Buffalo, NY 14203-1560

Other names 1

NPPES NPI Registry
  • Kenmore Mercy Professional Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2020.

{
    "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": "193200000X MULTI-SPECIALTY 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.