NPIMap

Individual provider Active NPI

John M Roehmholdt, MD

  • Urology Physician
  • Cheektowaga, NY
National Provider Identifier
1801886965
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
167540 Issued in NY
Practice address
3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225-2563
Phone
(716) 844-5000
Fax
(716) 844-5050
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 167540 NY Primary

Addresses

Primary practice location

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225-2563

Mailing address

3085 Harlem Rd
Suite 350
Cheektowaga, NY 14225-2591
Phone (716) 844-5600

Other identifiers 6

IdentifierTypeStateIssuer
00010149702OtherNYUNIVERA
070322000078OtherNYFIDELIS
P00368540OtherNYRR MEDICARE
145176OtherNYWORKERS COMP
000527023004OtherNYBCBS OF WNY
1903219OtherNYIHA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001197 NY Practitioner - Urology 3971491861 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albany Medical College of Union University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physician PCGroup PAC ID 9133434269, 65 clinicians

Practice addresses (Care Compare)

3085 Harlem Rd
Suite 200
Cheektowaga, NY 14225-2591
Phone (716) 844-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.58 of 100Reported as group
Quality
39.81
Promoting interoperability
88
Improvement activities
40
Cost
83.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection14
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Nov 21, 2018 Accepting new patients
Erie County Medical Center Corporation CurrentSince Nov 21, 2018 Accepting new patients
Great Lakes Physician, PC Urology CurrentSince Jul 13, 2015 Accepting new patients
Harlem Road Ambulatory Surgery Center LLC CurrentSince Oct 10, 2023 Accepting new patients

Locations

726 Exchange St
Ste 200
Buffalo, NY 14210

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 300
Cheektowaga, NY 14225
Phone (716) 422-5422

3085 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225
Phone (716) 844-5000

500 Sterling Dr
Orchard Park, NY 14127
Phone (716) 677-2273

3850 Saunders Settlement Rd
Sanborn, NY 14132
Phone (716) 898-2800

Organizations & group practices 6

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 10

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1801886965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 HARLEM RD",
            "address_2": "SUITE 350",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252591",
            "telephone_number": "716-844-5600",
            "fax_number": "716-844-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 HARLEM RD",
            "address_2": "STE 200",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142252563",
            "telephone_number": "716-844-5000",
            "fax_number": "716-844-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHMHOLDT",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "167540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010149702",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "070322000078",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00368540",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "145176",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WNY",
            "identifier": "000527023004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1903219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.