Individual provider Active NPI

Robert Kuchuk, M.D.

  • Specialist
  • Buffalo, NY
National Provider Identifier
1942526652
Registry record updated Feb 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
271611 Issued in NY
Practice address
2121 Main St
Suite # 119
Buffalo, NY 14214-2693
Phone
(716) 838-6655
Fax
(716) 838-6652
NPI assigned
Apr 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Specialist 174400000X 271611 NY Primary

Addresses

Primary practice location

2121 Main St
Suite # 119
Buffalo, NY 14214-2693

Mailing address

2121 Main St
Suite Number 119
Buffalo, NY 14214-2693
Phone (716) 838-6655

Other identifiers 1

IdentifierTypeStateIssuer
03723897MedicaidNY

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
I20160906000212 NY Practitioner - Pediatric Medicine 5698061430 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Jun 6, 2016 Accepting new patients
Kenwood Pediatrics Specialist PastSince Apr 26, 2020 Accepting new patients

Locations

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

3101 9th St
Niagara Falls, NY 14305
Phone (716) 284-8917

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391299200000",
    "number": "1942526652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MAIN ST",
            "address_2": "SUITE NUMBER 119",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142693",
            "telephone_number": "716-838-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MAIN ST",
            "address_2": "SUITE # 119",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142693",
            "telephone_number": "716-838-6655",
            "fax_number": "716-838-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHUK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2014-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "271611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03723897",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.