NIAGARA INTERNAL MEDICINE
NPI 1053696997
Internal Medicine in Erie, PA

Q: What is Lake Erie Medical Group PC's NPI number?

The NPI number for Lake Erie Medical Group PC is 1053696997. It was assigned to this organization in the NPPES registry on October 11, 2011. The provider is also known as Niagara Internal Medicine.

Q: What is Lake Erie Medical Group PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since October 11, 2011

2501 W 12TH ST STE C10, ERIE, PA 16505(814) 580-5600(814) 455-2584 Get Directions Write a Review

NPPES record last updated: December 15, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 15, 2020, Oct 6, 2020, Jan 31, 2017 (3 updates tracked since 2017).

On this page

About Niagara Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIAGARA INTERNAL MEDICINE (NPI 1053696997) is a healthcare organization registered as an internal medicine in Erie, Pennsylvania and active in the NPI registry since October 2011. The organization lists Tamara L Hatt, Senior Enrollment Specialist, as its authorized official.

NPPES Registry Identity

NPI1053696997

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameLAKE ERIE MEDICAL GROUP PC

Location Address2501 W 12TH ST STE C10Erie, PA 16505-4527

Mailing Address2501 W 12th St Ste C10Erie, PA 16505-4527 · (814) 580-5600 · Fax (814) 455-2584

Phone(814) 580-5600

Fax(814) 455-2584

Organization SubpartNo

Authorized OfficialTamara L HattSenior Enrollment Specialist · (814) 452-5772

Enumeration DateOctober 11, 2011

Last NPPES UpdateDecember 15, 20203 updates tracked since enumeration

NPPES CertifiedDecember 15, 2020

✔ NPI 1053696997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

2501 W 12TH ST STE C10, Erie, PA 16505

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Other Names 1

Other NameNiagara Internal Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Niagara Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 22 clinicians reassign Medicare billing to Niagara Internal Medicine, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 11 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Internal Medicine11

Family Practice5

Hospitalist3

Nurse Practitioner1

Physical Medicine and Rehabilitation1

Registered Dietitian or Nutrition Professional1

Nearest to this location (20)

See all 22

Kelly Kopkowski, DO

Physical Medicine and Rehabilitation

NPI 1386839405

2501 W 12TH ST STE C10
Erie, PA 16505

(814) 580-5600

✔ PECOSSame address

John Mingey, MD

Internal Medicine

NPI 1578514352

2501 W 12TH ST
Erie, PA 16505

(814) 461-6626

✔ PECOSSame address

Jennifer Potthoff, RD, LDN

Registered Dietitian or Nutrition Professional

NPI 1427437896

2501 W 12TH ST
Erie, PA 16505

(814) 461-6626

✔ Accepts MedicareSame address

Kailey Tarbell, CRNP

Nurse Practitioner

NPI 1497202931

2500 W 12TH ST STE C
Erie, PA 16505

(814) 877-8730

✔ PECOS✔ Accepts Medicare0.1 mi

Philip St. Julien, D.O.

Family Practice

NPI 1841580750

4247 W RIDGE RD STE 105
Erie, PA 16506

(814) 838-2468

✔ PECOS✔ Accepts Medicare2.6 mi

Jason Estrada, MD

Internal Medicine

NPI 1184665119

232 W 25TH ST
Erie, PA 16544

(814) 452-5980

✔ PECOS2.9 mi

Maged Ghanem, MD

Internal Medicine

NPI 1306854948

232 W 25TH ST
Erie, PA 16544

(814) 452-5980

✔ PECOS✔ Accepts Medicare2.9 mi

Mauro Quaglia, MD

Internal Medicine

NPI 1366483190

232 W 25TH ST
Erie, PA 16544

(814) 452-5000

✔ PECOS✔ Accepts Medicare3.0 mi

Stanley Slabic, M.D.

Internal Medicine

NPI 1285626358

232 W 25TH ST
Erie, PA 16544

(814) 452-7605

✔ PECOS3.5 mi

Maribelle Gauna-Estrada, MD

Internal Medicine

NPI 1093887200

213 E 41ST ST
Erie, PA 16504

(814) 864-4987

✔ PECOS✔ Accepts Medicare3.9 mi

Donald Unger, DO

Family Practice

NPI 1700824299

4950 BUFFALO RD
Erie, PA 16510

(814) 898-2576

✔ PECOS✔ Accepts Medicare8.2 mi

Joshua Czerwinski, D.O.

Family Practice

NPI 1174813406

5165 IMPERIAL PKWY
Girard, PA 16417

(814) 774-3128

✔ PECOS✔ Accepts Medicare11 mi

Jennifer Wilson, M.D.

Family Practice

NPI 1205958022

751 LIBERTY ST
Meadville, PA 16335

(814) 333-7016

✔ PECOS✔ Accepts Medicare32 mi

Sonia Brar, MD

Internal Medicine

NPI 1487965364

12351 PERRY HWY
Wexford, PA 15090

(412) 359-3030

✔ PECOS✔ Accepts Medicare101 mi

Abdelsalam Ahmed, MD

Hospitalist

NPI 1083628119

202 BEACHLEY ST
Meyersdale, PA 15552

(814) 634-5935

✔ PECOS✔ Accepts Medicare168 mi

Pravinkumar Patel, M.D.

Internal Medicine

NPI 1962631242

420 S 5TH AVE
West Reading, PA 19611

(484) 628-5455

✔ PECOS✔ Accepts Medicare250 mi

Mohamed Jamaldeen, M.D.

Hospitalist

NPI 1871737643

2060 WESTGATE DR APT G9
Bethlehem, PA 18017

(347) 216-0086

✔ PECOS✔ Accepts Medicare266 mi

Navneet Bhullar, M.D.

Internal Medicine

NPI 1154364818

800 SPRUCE ST PINE 1 WEST
Philadelphia, PA 19107

(215) 829-7817

✔ PECOS300 mi

Pooja Patel, M.D.

Hospitalist

NPI 1821228644

188 MARKET ST
Perth Amboy, NJ 08861

(732) 441-4251

✔ PECOS✔ Accepts Medicare324 mi

Leah Campbell, D.O.

Family Practice

NPI 1730524364

9540 PARK MEADOWS DR
Lone Tree, CO 80124

(720) 848-0000

✔ PECOS✔ Accepts Medicare1,304 mi

See all 22 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Erie Medical Group PC's NPI number?

The NPI number for Lake Erie Medical Group PC is 1053696997. It was assigned to this organization in the NPPES registry on October 11, 2011. The provider is also known as Niagara Internal Medicine.

Where is Lake Erie Medical Group PC located?

Lake Erie Medical Group PC is located at 2501 W 12th St Ste C10, Erie, PA 16505. The listed phone number is (814) 580-5600.

What is Lake Erie Medical Group PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lake Erie Medical Group PC enrolled in Medicare?

Yes. Lake Erie Medical Group PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Erie Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 6 Medicare specialties reassign their Medicare billing to Lake Erie Medical Group PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (11), Family Practice (5) and Hospitalist (3). Of these, 3 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lake Erie Medical Group PC was last updated on December 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.