Individual provider Active NPI

Elizabeth Anne Freck, M.D.

  • Anesthesiology Physician
  • Williamsville, NY
National Provider Identifier
1821237181
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
276033-1 Issued in NY
Practice address
30 S Cayuga Rd
Williamsville, NY 14221-6728
Phone
(716) 632-1089
NPI assigned
Feb 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009-00929 NC
Anesthesiology Physician 207L00000X D72597 MD
Anesthesiology Physician 207L00000X 276033-1 NY Primary

Addresses

Primary practice location

30 S Cayuga Rd
Williamsville, NY 14221-6728

Mailing address

30 S Cayuga Rd
Williamsville, NY 14221-6728
Phone (716) 632-1089

Other identifiers 2

IdentifierTypeStateIssuer
046747200MedicaidMD
5913693MedicaidNC

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
I20161208000613 NY Practitioner - Anesthesiology 2062566243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Gate Anesthesiologists, P.C.Group PAC ID 8022913839, 113 clinicians

Practice addresses (Care Compare)

1540 Maple Rd
Williamsville, NY 14221-3647
Phone (716) 632-1088

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-00929NCMDAnesthesiology Physician
276033-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Gate Anesthesiologists, P.C. Anesthesiology CurrentSince Nov 29, 2016 Accepting new patients

Locations

875 Ellicott St
Buffalo, NY 14203
Phone (716) 748-2000

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

2568 Walden Ave
Ste 103
Cheektowaga, NY 14225

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

495 International Dr
Williamsville, NY 14221
Phone (716) 565-3999

30 S Cayuga Rd
Williamsville, NY 14221

215 Klein Rd
Williamsville, NY 14221
Phone (716) 568-6100

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

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 6

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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1821237181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S CAYUGA RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216728",
            "telephone_number": "716-632-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S CAYUGA RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216728",
            "telephone_number": "716-632-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRECK",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2009-00929",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D72597",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "276033-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046747200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913693",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.