Individual provider Active NPI

Michael Paul Kane, MD

  • Family Medicine Physician
  • Hamburg, NY
National Provider Identifier
1790728004
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
215824 Issued in NY
Practice address
4855 Camp Rd
Suite 100
Hamburg, NY 14075
Phone
(716) 646-1084
Fax
(716) 646-0763
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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 215824 NY Primary

Addresses

Primary practice location

4855 Camp Rd
Suite 100
Hamburg, NY 14075

Mailing address

4855 Camp Rd
Suite 100
Hamburg, NY 14075
Phone (716) 646-1084

Other identifiers 2

IdentifierTypeStateIssuer
002273045MedicaidNY
405029OtherNYWELLCARE

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
I20100219000630 NY Practitioner - Family Practice 2769576669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Primary Care Associates, LLPGroup PAC ID 9931013703, 13 clinicians

Practice addresses (Care Compare)

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions49
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215824NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Primary Care Associates LLP Family Medicine CurrentSince Jun 1, 2002 Accepting new patients

Locations

571 Terrace Blvd
Depew, NY 14043
Phone (716) 683-4196

4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084

Interoperability endpoints

  • Direct secure messaging: mpkane@lakeshorepca.medentdirect.com

Organizations & group practices 1

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 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1790728004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "14075",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "14075",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "215824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002273045",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "405029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.