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CANALSIDE PRIMARY CARE PC
NPI 1174651046
Family Medicine in North Tonawanda, NY

Active since March 01, 2007CLIA 33D2332774 · Waiver
43 NIAGARA ST, NORTH TONAWANDA, NY 14120(716) 690-2001(716) 690-2239 Get Directions Write a Review

NPPES record last updated: December 26, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 26, 2019, Jul 15, 2019, Mar 4, 2019 (3 updates tracked since 2019).

About Canalside Primary Care Pc NPPES

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

CANALSIDE PRIMARY CARE PC (NPI 1174651046), doing business as Lynne Ross Md Pc, is a healthcare organization registered as a family medicine in North Tonawanda, New York and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through October 23, 2027 and lists Lynne Susan Ross, Owner, as its authorized official.

NPPES Registry Identity

NPI1174651046
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCANALSIDE PRIMARY CARE PC
Location Address43 NIAGARA STNorth Tonawanda, NY 14120-6115
Mailing Address908 Niagara Falls Blvd Ste 208North Tonawanda, NY 14120-2019 · (716) 692-3302 · Fax (716) 692-4342
Phone(716) 690-2001
Fax(716) 690-2239
Organization SubpartNo
Authorized OfficialLynne Susan RossOwner · (716) 690-2001
Enumeration DateMarch 1, 2007
Last NPPES UpdateDecember 26, 20193 updates tracked since enumeration
✔ NPI 1174651046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 229399
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

43 NIAGARA ST, North Tonawanda, NY 14120
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Other Names 1

Former Legal Business NameLynne Ross Md Pc

Other Identifiers 1

Medicaid02494544NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2332774

Canalside Primary Care PC · North Tonawanda, NY
Active · expires Oct 23, 2027
CLIA Number33D2332774
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2025
Certificate Expiration DateOctober 23, 2027
Laboratory DirectorLynne S. Ross
Laboratory Phone(716) 690-2001
Laboratory LocationCanalside Primary Care PC43 Niagara Street, North Tonawanda, NY 14120
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYNN LOUISE SIMMONS
Physician Assistant
43 NIAGARA ST
NORTH TONAWANDA, NY 14120
Niagara County (716) 690-2001
LYNNE S ROSS MD
Family Medicine
43 NIAGARA ST
NORTH TONAWANDA, NY 14120
Niagara County (716) 690-2001
SHAN HAWRAMEE PA-C
Physician Assistant
43 NIAGARA ST
NORTH TONAWANDA, NY 14120
Niagara County (716) 690-2001
ALYSSA WEAVER PA-C
Physician Assistant
43 NIAGARA ST
NORTH TONAWANDA, NY 14120
Niagara County (716) 690-2001
STEPHANY RUSZALA PA-C
Physician Assistant
43 NIAGARA ST
NORTH TONAWANDA, NY 14120
Niagara County (716) 690-2001

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 Canalside Primary Care PC's NPI number?

The NPI number for Canalside Primary Care PC is 1174651046. It was assigned to this organization in the NPPES registry on March 1, 2007. The provider was formerly known as Lynne Ross MD PC.

Where is Canalside Primary Care PC located?

Canalside Primary Care PC is located at 43 Niagara St, North Tonawanda, NY 14120. The listed phone number is (716) 690-2001.

What is Canalside Primary Care PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Canalside Primary Care PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2332774) is associated with this NPI, valid through October 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Canalside Primary Care PC was last updated on December 26, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.