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GREAT LAKES UROLOGY PLLC
NPI 1063203859
Urology in Cheektowaga, NY

Active since May 13, 2025
3085 HARLEM RD STE 200, CHEEKTOWAGA, NY 14225(716) 844-5000(716) 844-5750 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Great Lakes Urology Pllc NPPES

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

GREAT LAKES UROLOGY PLLC (NPI 1063203859) is a healthcare organization registered as an urology in Cheektowaga, New York and active in the NPI registry since May 2025. The organization lists K Kent Chevli, Managing Physician, as its authorized official.

NPPES Registry Identity

NPI1063203859
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGREAT LAKES UROLOGY PLLC
Location Address3085 HARLEM RD STE 200Cheektowaga, NY 14225-2591
Mailing Address3085 Harlem Rd Ste 350Cheektowaga, NY 14225-2591 · (716) 844-5600 · Fax (168) 445-7507
Phone(716) 844-5000
Fax(716) 844-5750
Organization SubpartNo
Authorized OfficialK Kent ChevliManaging Physician · (716) 844-5600
Enumeration DateMay 13, 2025
NPPES CertifiedMay 13, 2025
✔ NPI 1063203859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
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.
3085 HARLEM RD STE 200, Cheektowaga, NY 14225
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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)

Great Lakes Urology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

56

Medicare enrollment records show 56 clinicians reassign Medicare billing to Great Lakes Urology PLLC, which bills Medicare for the services they deliver. Of these, 28 practice at this address and 38 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Urology30
Nurse Practitioner12
Radiation Oncology7
Obstetrics/Gynecology3
Certified Registered Nurse Anesthetist (CRNA)2
Pathology1
Physical Therapist in Private Practice1

Nearest to this location (20)

See all 56
David Abramowitz, M.D.
Urology
NPI 1265850390
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
John Barlog, MD
Urology
NPI 1629633714
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
John Bodkin, MD
Urology
NPI 1144464942
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Cassandra Busch, NP
Nurse Practitioner
NPI 1831859610
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Eric Chevli, MD
Urology
NPI 1396365417
3085 HARLEM RD STE 200
Buffalo, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
K Chevli, M.D.
Urology
NPI 1215934781
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Costanzo, DNP
Nurse Practitioner
NPI 1841967395
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5600
✔ PECOS✔ Accepts MedicareSame address
Teresa Danforth, MD
Urology
NPI 1285877522
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Brian Dinerman, MD
Urology
NPI 1174054506
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Abeer Eddib, MD
Obstetrics/Gynecology
NPI 1215954102
3085 HARLEM RD SUITE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Jacquelyn Gonka-Griffo, MD
Urology
NPI 1902292733
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Sarah Heller, FNP
Nurse Practitioner
NPI 1962145086
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5600
✔ PECOS✔ Accepts MedicareSame address
Paige Hileman, NP
Nurse Practitioner
NPI 1770460842
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Catherine Metzger, MD
Obstetrics/Gynecology
NPI 1922597806
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Cara Partridge, FNP
Nurse Practitioner
NPI 1376125583
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Rachel Smith, AGPCNP-BC
Nurse Practitioner
NPI 1356748552
3085 HARLEM RD STE 200
Buffalo, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Sarah Ward, M.D.
Obstetrics/Gynecology
NPI 1255794418
3085 HARLEM RD STE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ PECOS✔ Accepts MedicareSame address
Amy Walter, P.T., D.P.T.
Physical Therapist in Private Practice
NPI 1477707198
3085 HARLEM ROAD SUITE 200
Cheektowaga, NY 14225
(716) 844-5000
✔ Accepts MedicareSame address
Michael Duff, M.D.
Radiation Oncology
NPI 1083648646
3085 HARLEM RD STE 100
Cheektowaga, NY 14225
(716) 844-5500
✔ PECOS✔ Accepts MedicareSame address
Dhiren Shah, MD
Radiation Oncology
NPI 1427011782
3085 HARLEM RD
Cheektowaga, NY 14225
(716) 844-5500
✔ PECOS✔ Accepts MedicareSame address
See all 56 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 Great Lakes Urology PLLC's NPI number?

The NPI number for Great Lakes Urology PLLC is 1063203859. It was assigned to this organization in the NPPES registry on May 13, 2025.

Where is Great Lakes Urology PLLC located?

Great Lakes Urology PLLC is located at 3085 Harlem Rd Ste 200, Cheektowaga, NY 14225. The listed phone number is (716) 844-5000.

What is Great Lakes Urology PLLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Great Lakes Urology PLLC enrolled in Medicare?

Yes. Great Lakes Urology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Lakes Urology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 56 clinicians in 7 Medicare specialties reassign their Medicare billing to Great Lakes Urology PLLC. 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 Urology (30), Nurse Practitioner (12) and Radiation Oncology (7). Of these, 28 practice at this address and 38 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 Great Lakes Urology PLLC was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.