GREAT LAKES PHYSICIAN, PC
NPI 1720045792
Urology in Cheektowaga, NY
NPI Status: Active since April 26, 2006
Contact Information
3085 HARLEM RD
SUITE 350
CHEEKTOWAGA, NY
ZIP 14225
Phone: (716) 844-5000
Fax: (716) 844-5050
- Organization
- Urology
- CLIA Number: 33D0702730
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-06-2026
About GREAT LAKES PHYSICIAN, PC
This page provides the complete NPI Profile along with additional information for Great Lakes Physician, Pc, a provider established in Cheektowaga, New York operating as a Urology. The healthcare provider is registered in the NPI registry with number 1720045792 assigned on April 2006. The practitioner's primary taxonomy code is 208800000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Great Lakes Physician, Pc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's former legal business name is Western New York Urology Associates Llc. The authorized official of this NPI record is K Kent Chevli M.d. (Managing Physician)
- NPI
- 1720045792
- Provider Legal Name
- GREAT LAKES PHYSICIAN, PC
- Other Organization Name
- WESTERN NEW YORK UROLOGY ASSOCIATES LLC
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 3085 HARLEM RD SUITE 350 CHEEKTOWAGA, NY 14225
- Location Phone
- (716) 844-5000
- Location Fax
- (716) 844-5050
- Mailing Address
- 3085 HARLEM RD SUITE 350 CHEEKTOWAGA, NY 14225
- Mailing Phone
- (716) 844-5000
- Mailing Fax
- (716) 844-5050
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-26-2006
- Last Update Date
- 04-25-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207ZP0105X | Allopathic & Osteopathic Physicians | Pathology | |
| 2 | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 03869087 | MEDICAID (05) | NY |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D0702730
- Facility Type
- Physician Office
- Certificate Effective Date
- October 07, 2024
- Certificate Expiration Date
- October 06, 2026
- Laboratory Director
- DR. JOSEPH M. GRECO
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Great Lakes Physician, Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 0 | 4 | 5 | 7 | 9 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 0 | 4 | 10 | 7 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 0 + 4 + 1 + 0 + 7 + 1 + 8 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1720045792 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1205876067 | APEX IMAGING I, P.C. Organization | Radiology (Diagnostic Radiology) | 3085 HARLEM RD CHEEKTOWAGA, NY 14225 (716) 859-2954 |
| 1265461917 | MAXIM MANAGEMENT SERVICES Organization | Exclusive Provider Organization | 3085 HARLEM RD STE 350 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1215954102 | DR. ABEER EDDIB MD Individual | Urology (Urogynecology and Reconstructive Pelvic Surgery) | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1427271063 | WESTERN NEW YORK UROLOGY ASSOCIATES, LLC Organization | Radiology (Radiation Oncology) | 3085 HARLEM RD CHEEKTOWAGA, NY 14225 (716) 844-5500 |
| 1215224365 | INTEGRATED CLINICAL SERVICES Organization | Urology | 3085 HARLEM RD STE 350 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1316200348 | MRS. EMMA L HARRINGTON F.N.P. Individual | Nurse Practitioner (Family) | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1487650016 | DR. JOSEPH M GRECO M.D. Individual | Urology | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1841297496 | DR. CHRISTOPHER J SKOMRA M.D. Individual | Urology | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1336146984 | DR. RICHARD N GILBERT M.D. Individual | Urology | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1174520696 | KEVIN J BARLOG M.D. Individual | Urology | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1497752919 | EMILY A LEVANDUSKY P.A. Individual | Physician Assistant | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1659378180 | BRIAN C CROTZER P.A. Individual | Physician Assistant | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1215934781 | DR. K KENT CHEVLI M.D. Individual | Urology | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1801886965 | DR. JOHN M ROEHMHOLDT MD Individual | Urology | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1437347820 | MRS. CHRISTINA M CAMPOLO RPA-C Individual | Physician Assistant | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1568627339 | JAIME FETES PA Individual | Physician Assistant (Medical) | 3085 HARLEM RD STE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1356391395 | JESSICA MITCHELL PA-C Individual | Physician Assistant | 3085 HARLEM RD SUITE 350 CHEEKTOWAGA, NY 14225 (716) 844-5600 |
| 1194169599 | MS. KAREN ANNE PANE ANP Individual | Nurse Practitioner (Adult Health) | 3085 HARLEM RD SUITE 200 CHEEKTOWAGA, NY 14225 (716) 844-5000 |
| 1639153943 | DR. TRUDY REID BAKER MD Individual | Obstetrics & Gynecology (Gynecologic Oncology) | 3085 HARLEM RD STE 300 CHEEKTOWAGA, NY 14225 (716) 422-5422 |
| 1083648646 | DR. MICHAEL DUFF M.D. Individual | Radiology (Radiation Oncology) | 3085 HARLEM RD STE 100 CHEEKTOWAGA, NY 14225 (716) 844-5500 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720045792, enumerated in the NPI registry as an "organization" on April 26, 2006
The provider is located at 3085 Harlem Rd Suite 350 Cheektowaga, Ny 14225 and the phone number is (716) 844-5000
This medical organization specializes in Urology with taxonomy code 208800000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 33D0702730 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on April 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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