NPIMap

Organization Active NPI

Erie County Public Health Laboratory

  • Clinical Medical Laboratory
  • Buffalo, NY
National Provider Identifier
1790865145
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
PFI1980 Issued in NY
Legal business name
ERIE COUNTY PUBLIC HEALTH LABORATORY
Practice address
503 Kensington Ave
Building Aa, Room Aa19
Buffalo, NY 14214-2804
Phone
(716) 898-6100
Fax
(716) 898-6110
NPI assigned
Oct 17, 2006
Last updated
May 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Ms. Carleen M. Pope, M.S., M.P.H.
Title
Administrative Coord
Phone
(716) 898-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X PFI1980 NY Primary

Addresses

Primary practice location

503 Kensington Ave
Building Aa, Room Aa19
Buffalo, NY 14214-2804

Mailing address

503 Kensington Ave
Building Aa, Room Aa19
Buffalo, NY 14214-2804
Phone (716) 898-6100

Other identifiers 1

IdentifierTypeStateIssuer
00623767MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220711003078 NY Part B Supplier - Independent Clinical Laboratory 8325029374 Practice locations: Buffalo, NY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0654777Erie County Public Health Laboratory503 Kensington Ave, Buffalo, NY 14214ComplianceMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Jenia Sherif MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

503 Kensington Ave
Bldg Aa
Buffalo, NY 14214
Phone (716) 898-6100

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1790865145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 KENSINGTON AVE",
            "address_2": "BUILDING AA, ROOM AA19",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142804",
            "telephone_number": "716-898-6100",
            "fax_number": "716-898-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 KENSINGTON AVE",
            "address_2": "BUILDING AA, ROOM AA19",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142804",
            "telephone_number": "716-898-6100",
            "fax_number": "716-898-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE COUNTY PUBLIC HEALTH LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "CARLEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATIVE COORD",
        "authorized_official_telephone_number": "716-898-6100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., M.P.H."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "PFI1980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00623767",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.