NPIMap

Organization Active NPI

Family Choice of New York Medical PC

  • General Practice Physician
  • Depew, NY
National Provider Identifier
1720312754
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FAMILY CHOICE OF NEW YORK MEDICAL PC
Practice address
3332 Walden Ave
Suite 110
Depew, NY 14043
Phone
(716) 668-7051
Fax
(716) 668-7069
NPI assigned
Sep 23, 2009
Last updated
Jun 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Dr. Stephen EvansNPI 1730172776
Title
Chief Medical Officer
Phone
(716) 668-7051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X NY Primary

Addresses

Primary practice location

3332 Walden Ave
Suite 110
Depew, NY 14043

Mailing address

3332 Walden Ave
Suite 110
Depew, NY 14043
Phone (716) 668-7051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170927003380 NY Part B Supplier - Clinic/Group Practice 1355615477 Receives reassigned benefits from 17 practitioners
Practice locations: Depew, NY

National Provider Directory

National Provider Directory

Locations

3332 Walden Ave
Ste 110
Depew, NY 14043
Phone (716) 668-7051

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1720312754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 WALDEN AVE",
            "address_2": "SUITE 110",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "14043",
            "telephone_number": "716-668-7051",
            "fax_number": "716-668-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 WALDEN AVE",
            "address_2": "SUITE 110",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "14043",
            "telephone_number": "716-668-7051",
            "fax_number": "716-668-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHOICE OF NEW YORK MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "716-668-7051",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.