NPIMap

Individual provider Active NPI

Amy Lynn Peterson

  • Family Medicine Physician
  • Lake View, NY
National Provider Identifier
1700390754
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
021394-1 Issued in NY
Practice address
2816 Pleasant Ave
Lake View, NY 14085-9624
Phone
(716) 646-5500
NPI assigned
Nov 29, 2017
Last updated
Nov 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 021394-1 NY Primary

Addresses

Primary practice location

2816 Pleasant Ave
Lake View, NY 14085-9624

Mailing address

837 Sun Valley Dr
North Tonawanda, NY 14120-1923
Phone (716) 715-7403

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
I20180405001753 NY Practitioner - Physician Assistant 9739442625 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
Group practices
Preferred Physician Care PCGroup PAC ID 5799945911, 26 clinicians

Practice addresses (Care Compare)

5844 Southwestern Blvd
Suite 500
Hamburg, NY 14075-3684
Phone (716) 646-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021394-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Physician Care, PC Family Medicine CurrentSince Sep 11, 2025 Accepting new patients

Locations

5844 Southwestern Blvd
Ste 500
Hamburg, NY 14075
Phone (716) 646-5500

2816 Pleasant Ave
Lake View, NY 14085
Phone (716) 348-2759

30 N Union Rd
Ste 101
Williamsville, NY 14221
Phone (716) 633-6363

Interoperability endpoints

  • Direct secure messaging: apetersonpa@premierhealthpartners.medentdirect.com

Organizations & group practices 2

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1700390754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 SUN VALLEY DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201923",
            "telephone_number": "716-715-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 PLEASANT AVE",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859624",
            "telephone_number": "716-646-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "021394-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake View, NY

Sources for this page

Verify at the official NPI Registry.