Organization Active NPI

Kostas N Botsoglou MD LLC

  • Rheumatology Physician
  • Cheektowaga, NY
National Provider Identifier
1780076943
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
262576 Issued in NY
Legal business name
KOSTAS N BOTSOGLOU MD LLC
Practice address
2475 Harlem Rd
Cheektowaga, NY 14225-4558
Phone
(716) 322-5428
NPI assigned
Feb 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Kostas N BotsoglouNPI 1295981652
Title
Owner
Phone
(716) 863-1432

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
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X 262576 NY Primary

Addresses

Primary practice location

2475 Harlem Rd
Cheektowaga, NY 14225-4558

Mailing address

2475 Harlem Rd
Cheektowaga, NY 14225-4558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240116001384 NY Part B Supplier - Clinic/Group Practice 8426400458 Receives reassigned benefits from 4 practitioners
Practice locations: Cheektowaga, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1780076943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254558",
            "telephone_number": "716-322-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSTAS N BOTSOGLOU MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "BOTSOGLOU",
        "authorized_official_first_name": "KOSTAS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-863-1432"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "262576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.