Individual provider Active NPI

David L Hallasey-Roberts, MD

  • Family Medicine Physician
  • West Seneca, NY
National Provider Identifier
1750348082
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
175084 Issued in NY
Practice address
1026 Union Rd
West Seneca, NY 14224-3445
Phone
(716) 712-1000
Fax
(716) 712-0853
NPI assigned
Apr 28, 2006
Last updated
Jul 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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 175084 NY Primary

Addresses

Primary practice location

1026 Union Rd
West Seneca, NY 14224-3445

Mailing address

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-1000

Other identifiers 1

IdentifierTypeStateIssuer
01538949MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000751 NY Practitioner - Family Practice 8022047497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks-TLC Hospital System, Inc. CurrentSince Jan 15, 2020 Accepting new patients
Southgate Medical Group,LLP Past Accepting new patients
John P. Ward Family Medicine Past Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

34 Commercial St
Gowanda, NY 14070
Phone (716) 532-3377

Interoperability endpoints

  • Direct secure messaging: david.hallasey@btlc.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1750348082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-1000",
            "fax_number": "716-712-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-1000",
            "fax_number": "716-712-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLASEY-ROBERTS",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "175084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01538949",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.