Active NPI
Kenneth H Eckhert Jr., M.D.
- Surgery Physician
- Williamsville, NY
National Provider Identifier
1972581965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 104222
- Practice address
- 295 Essjay Rd
Williamsville, NY 14221-8216 - Phone
- (716) 630-1477
- Fax
- (716) 250-5936
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 104222 | NY | Primary |
Addresses
Primary practice location
295 Essjay Rd
Williamsville, NY 14221-8216
Mailing address
6255 Sheridan Dr
Suite 304
Williamsville, NY 14221-4836
Phone (716) 857-8666
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1706284 | Other | NY | IHA |
| 050908000011 | Other | NY | FIDELIS |
| 00681810 | Medicaid | NY | |
| 00010050002 | Other | NY | UNIVERA |
| 000505901008 | Other | NY | HEALTH NOW |
| 198214 | Other | NY | GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104222 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1972581965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6255 SHERIDAN DR",
"address_2": "SUITE 304",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214836",
"telephone_number": "716-857-8666",
"fax_number": "716-857-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 ESSJAY RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142218216",
"telephone_number": "716-630-1477",
"fax_number": "716-250-5936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKHERT",
"first_name": "KENNETH",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "104222",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA",
"identifier": "1706284",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "050908000011",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00681810",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00010050002",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NOW",
"identifier": "000505901008",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "198214",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.