NPIMap

Organization Active NPI

Orleans Medical PC

  • Medical Specialty Clinic/Center
  • Medina, NY
National Provider Identifier
1689724262
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ORLEANS MEDICAL PC
Practice address
11075 W Center Street Ext
Medina, NY 14103-9557
Phone
(585) 798-1053
Fax
(585) 798-5639
NPI assigned
Jan 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jill E Klotzbach, MSN, NPNPI 1881687127
Title
Office Manager
Phone
(585) 798-1053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

11075 W Center Street Ext
Medina, NY 14103-9557

Mailing address

11075 W Center Street Ext
Medina, NY 14103-9557
Phone (585) 798-1053

Other identifiers 2

IdentifierTypeStateIssuer
00642420MedicaidNY
02081836MedicaidNY

National Provider Directory

National Provider Directory

Locations

11075 W Center Street Ext
Medina, NY 14103
Phone (585) 798-1053

23 N Main St
Middleport, NY 14105
Phone (716) 735-3386

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689724262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11075 W CENTER STREET EXT",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141039557",
            "telephone_number": "585-798-1053",
            "fax_number": "585-798-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 W CENTER STREET EXT",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141039557",
            "telephone_number": "585-798-1053",
            "fax_number": "585-798-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLEANS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLOTZBACH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "585-798-1053",
        "authorized_official_credential": "MSN, NP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00642420",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02081836",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.