GREAT LAKES PHYSICIAN, PC
NPI 1720045792
Urology in Cheektowaga, NY
About Great Lakes Physician, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT LAKES PHYSICIAN, PC (NPI 1720045792), doing business as Western New York Urology Associates Llc, is a healthcare organization registered as an urology in Cheektowaga, New York and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through November 4, 2027 and lists K Kent Chevli, Managing Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 1
Group Practice 1
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 Physician, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
55Medicare enrollment records show 55 clinicians reassign Medicare billing to Great Lakes Physician, PC, which bills Medicare for the services they deliver. Of these, 28 practice at this address and 37 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 55Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 33D2174603
Great Lakes Physicians, PC Dba Western New York Urology Associates · Buffalo, NYFrequently 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 Physician, PC's NPI number?
The NPI number for Great Lakes Physician, PC is 1720045792. It was assigned to this organization in the NPPES registry on April 26, 2006. The provider was formerly known as Western New York Urology Associates LLC.
Where is Great Lakes Physician, PC located?
Great Lakes Physician, PC is located at 3085 Harlem Rd Suite 350, Cheektowaga, NY 14225. The listed phone number is (716) 844-5000.
What is Great Lakes Physician, PC's specialty?
The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.
Is Great Lakes Physician, PC enrolled in Medicare?
Yes. Great Lakes Physician, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Lakes Physician, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 55 clinicians in 7 Medicare specialties reassign their Medicare billing to Great Lakes Physician, 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 Urology (29), Nurse Practitioner (11) and Radiation Oncology (8). Of these, 28 practice at this address and 37 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Great Lakes Physician, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2174603) is associated with this NPI, valid through November 4, 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 Great Lakes Physician, PC was last updated on April 25, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Great Lakes Physician, Pc · NPI 1720045792
Urology organization in Cheektowaga, New York. Organization record, active in the CMS NPPES registry since April 26, 2006.
## Identity
- **NPI:** 1720045792 (Entity type: Organization)
- **Enumerated:** April 26, 2006
- **Primary specialty:** Urology · taxonomy 208800000X
- **Organization subpart:** No
- **Authorized official:** K Chevli, MANAGING PHYSICIAN
## Practice location
- **Address:** 3085 HARLEM RD, SUITE 350, Cheektowaga, NY 14225-2591
- **Phone:** (716) 844-5000 · **Fax:** (716) 844-5050
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 55 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Urology (29), Nurse Practitioner (11), Radiation Oncology (8); 28 practice at this address and 37 within 10 miles; [full list](https://npiprofile.com/npi/1720045792/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 25, 2017
- **Other identifiers:** Medicaid 03869087 (NY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1720045792) · Data from the CMS NPPES public registry.