Individual provider Active NPI

John K. Quinlivan, M.D.

  • Anesthesiology Physician
  • Cheektowaga, NY
National Provider Identifier
1760417414
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
174890-1 Issued in NY
Practice address
3095 Harlem Rd
Cheektowaga, NY 14225-2500
Phone
(716) 896-3815
Fax
(716) 896-3015
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 174890-1 NY Primary

Addresses

Primary practice location

3095 Harlem Rd
Cheektowaga, NY 14225-2500

Mailing address

4511 Harlem Rd RM 3
Amherst, NY 14226-3822
Phone (717) 886-0444

Other practice location 1

3921 Sheridan Dr
Amherst, NY 14226-1747
Phone (716) 250-6520

Other identifiers 1

IdentifierTypeStateIssuer
01260833MedicaidNY

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
I20120214000506 NY Practitioner - Anesthesiology 3577450691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southtowns Ambulatory Anesthesia PLLCGroup PAC ID 6103114764, 9 clinicians

Practice addresses (Care Compare)

303 Sterling Dr
Orchard Park, NY 14127-1570
Phone (716) 712-0600

Hospital & facility affiliations

  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174890-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southtowns Ambulatory Anesthesia PLLC Anesthesiology CurrentSince Mar 26, 2018 Accepting new patients
Buffalo Advanced Medical, P.C. Past Accepting new patients

Locations

303 Sterling Dr
Orchard Park, NY 14127
Phone (716) 712-0600

5959 Big Tree Rd
Orchard Park, NY 14127
Phone (716) 260-1593

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760417414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 HARLEM RD RM 3",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263822",
            "telephone_number": "717-886-0444",
            "fax_number": "716-885-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252500",
            "telephone_number": "716-896-3815",
            "fax_number": "716-896-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3921 Sheridan Dr",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142261747",
            "country_code": "US",
            "telephone_number": "716-250-6520",
            "fax_number": "716-250-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINLIVAN",
        "first_name": "JOHN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "174890-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01260833",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.