NPIMap

Individual provider Active NPI

Alexander Z Selioutski, M.D.

  • Family Medicine Physician
  • Mayville, NY
National Provider Identifier
1851360606
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209688 Issued in NY
Practice address
95 E Chautauqua St
Mayville, NY 14757-0168
Phone
(716) 753-7107
Fax
(716) 753-7980
NPI assigned
Mar 15, 2006
Last updated
Feb 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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 209688 NY Primary

Addresses

Primary practice location

95 E Chautauqua St
Mayville, NY 14757-0168

Mailing address

95 E Chautauqua St
PO Box 168
Mayville, NY 14757-0168
Phone (716) 753-7107

Other identifiers 4

IdentifierTypeStateIssuer
01958516MedicaidNY
000525727007OtherNYBCBSWNY
0110754OtherNYINDEPENDENT HEALTH
00020544403OtherNYUNIVERA

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
I20070305000116 NY Practitioner - Family Practice 3577665009 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Erie Medical Services PCGroup PAC ID 8123278215, 11 clinicians

Practice addresses (Care Compare)

268 W Main St
Suite 2
Fredonia, NY 14063-2200
Phone (716) 672-2000

3023 Route 430
Bemus Point, NY 14712-9778
Phone (716) 269-4430

529 Central Ave
Dunkirk, NY 14048-2514
Phone 7163389797610

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua Physicians PLLC Family Medicine CurrentSince Aug 27, 2025 Accepting new patients
Lake Erie Medical Services, PC CurrentSince Feb 4, 2025 Accepting new patients
Brooks - TLC Hospital System, Inc. CurrentSince Feb 7, 2023 Accepting new patients
Family Health Medical Services PLLC Family Medicine CurrentSince Apr 1, 2007 Accepting new patients
Brooks-TLC Hospital System, Inc. CurrentSince Feb 7, 2023 Accepting new patients
Gerry Homes Inc Past Accepting new patients
Brooks-TLC Hospital System, Inc. Past Accepting new patients
Gerry Homes Inc Past Accepting new patients
Chautauqua County Chapter of Nysarc Inc Past Accepting new patients
Absolut Center for Nursing and Rehabilitation at Westfield, LLC Past Accepting new patients
Pine Valley Central School Past Accepting new patients
Family Health Medical Services Jamestown Convenience Care Family Medicine PastSince Dec 1, 2010 Accepting new patients
Heritage Village Rehab & Skilled Nursing Inc Past Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

268 W Main St
Ste 2
Fredonia, NY 14063
Phone (716) 672-2000

3780 Eagle St
Fredonia, NY 14063
Phone (716) 672-3030

4570 Route 60
Gerry, NY 14740
Phone (716) 985-4612

845 Route 5 and 20
Irving, NY 14081
Phone (716) 593-1100

103 Allen St
Jamestown, NY 14701
Phone (716) 338-0022

150 Prather Ave
Jamestown, NY 14701
Phone (716) 269-4430

31 Sherman St
Ste 2200
Jamestown, NY 14701
Phone (716) 338-9797

31 Sherman St
Ste 2500
Jamestown, NY 14701
Phone (716) 338-9797

320 Prather Ave
Ste 200
Jamestown, NY 14701
Phone (716) 338-9797

715 Falconer St
Jamestown, NY 14701
Phone (716) 487-0141

95 E Chautauqua St
Mayville, NY 14757
Phone (716) 753-7107

216 E Main St
Westfield, NY 14787
Phone (716) 326-3240

Interoperability endpoints

  • Direct secure messaging: alexanderselioutskimd@lakeeriehealth.medentdirect.com
  • Direct secure messaging: aselioutski@fhms.medentdirect.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1851360606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 E CHAUTAUQUA ST",
            "address_2": "PO BOX 168",
            "city": "MAYVILLE",
            "state": "NY",
            "postal_code": "147570168",
            "telephone_number": "716-753-7107",
            "fax_number": "716-753-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E CHAUTAUQUA ST",
            "city": "MAYVILLE",
            "state": "NY",
            "postal_code": "147570168",
            "telephone_number": "716-753-7107",
            "fax_number": "716-753-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIOUTSKI",
        "first_name": "ALEXANDER",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01958516",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWNY",
            "identifier": "000525727007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0110754",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020544403",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayville, NY

Sources for this page

Verify at the official NPI Registry.