NPIMap

Organization Active NPI

Eastern Niagara Medical Group PC

  • Anesthesiology Physician
  • Lockport, NY
National Provider Identifier
1902913098
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
EASTERN NIAGARA MEDICAL GROUP PC
Practice address
5875 S Transit Rd
Lockport, NY 14094-6340
Phone
(716) 514-1166
Fax
(716) 514-5788
NPI assigned
Aug 24, 2006
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Dr. Hany Fattouch, M.D.NPI 1841267838
Title
President
Phone
(716) 389-3304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

5875 S Transit Rd
Lockport, NY 14094-6340

Mailing address

2372 Sweet Home Rd Ste 3
Amherst, NY 14228-2330
Phone (716) 389-3304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040512000175 NY Part B Supplier - Clinic/Group Practice 6901895002 Receives reassigned benefits from 29 practitioners
Practice locations: Lewiston, NY; Lockport, NY; Medina, NY; Amherst, NY

National Provider Directory

National Provider Directory

Locations

534 Main St
Ste 14
Medina, NY 14103
Phone (585) 798-3992

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1902913098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 SWEET HOME RD STE 3",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282330",
            "telephone_number": "716-389-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 S TRANSIT RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140946340",
            "telephone_number": "716-514-1166",
            "fax_number": "716-514-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NIAGARA MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "FATTOUCH",
        "authorized_official_first_name": "HANY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-389-3304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.