Ethan Leo Welch, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

81770 Issued in NY

Practice address

656 Admiralty Way
Webster, NY 14580-3904

Phone

(585) 787-0055

NPI assigned

Feb 14, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1962709733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 ADMIRALTY WAY",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803904",
            "telephone_number": "585-787-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 ADMIRALTY WAY",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803904",
            "telephone_number": "585-787-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "ETHAN",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "81770",
            "primary": true
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NY",
            "license": "81770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "81770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wegmans Food Markets, Inc.
• Wegmans Food Markets, Inc.
• Mary K Weir, RD
• Leslie S Weisbrod, M.D.
• Janet Ann Weisensel, LMSW
• Penny Suzette Weller, LCSW-R
• Natalie Lynn Welsh, RN
• Marla Wendel
• Todd A Wendel, O.D.
• Christine A Wesley, RN

• Specialist in Webster, NY
• Providers in Webster, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.