NPIMap

Individual provider Active NPI

Peterkin Lee-Kwen, MD

  • Neurology Physician
  • West Seneca, NY
National Provider Identifier
1811966880
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
206950 Issued in NY
Practice address
3775 Seneca St
West Seneca, NY 14224-3434
Phone
(716) 712-0890
Fax
(719) 712-0933
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 206950 NY Primary

Addresses

Primary practice location

3775 Seneca St
West Seneca, NY 14224-3434

Mailing address

3775 Seneca St
West Seneca, NY 14224-3434
Phone (716) 712-0890

Other identifiers 1

IdentifierTypeStateIssuer
01721420MedicaidNY

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
I20050310000887 NY Practitioner - Neurology 3476507526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southtowns Neurology of Western New York PCGroup PAC ID 9931116894, 3 clinicians

Practice addresses (Care Compare)

3775 Seneca St
West Seneca, NY 14224-3434
Phone (716) 712-0890

Hospital & facility affiliations

  • Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
58.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206950NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo CurrentSince Mar 11, 2013 Accepting new patients
CHS Neuroscience Group Neurology CurrentSince Mar 11, 2013 Accepting new patients
University Neurology, Inc. Neurology Past Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

Interoperability endpoints

  • Direct secure messaging: pleekwen21359@direct.chsbuffalo.org

Organizations & group practices 4

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 9

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1811966880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 SENECA ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243434",
            "telephone_number": "716-712-0890",
            "fax_number": "719-712-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 SENECA ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243434",
            "telephone_number": "716-712-0890",
            "fax_number": "719-712-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-KWEN",
        "first_name": "PETERKIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "206950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01721420",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.