GREAT LAKES PHYSICIAN PRACTICE PC
NPI 1730599176
Internal Medicine in Jamestown, NY
About Great Lakes Physician Practice Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT LAKES PHYSICIAN PRACTICE PC (NPI 1730599176) is a healthcare organization registered as an internal medicine in Jamestown, New York and active in the NPI registry since May 2014. The organization holds 3 active CLIA laboratory certificates and lists Patricia Devlin, Sr.director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 11
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 Practice Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
234Medicare enrollment records show 234 clinicians reassign Medicare billing to Great Lakes Physician Practice PC, which bills Medicare for the services they deliver. Of these, 32 practice at this address and 81 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 29
Nearest to this location (20)
See all 234Jamestown, NY 14701
Jamestown, NY 14701
Jamestown, NY 14701
Jamestown, NY 14701
Jamestown, NY 14701
Source: 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 3
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 33D0173900
Great Lakes Physician Practice PC Dba Glpp Family Practice · Jamestown, NYCertificate of Waiver 33D0956645
Great Lakes Physician Practice PC Dba Glpp Internal Medicine · Jamestown, NYCertificate for Provider-Performed Microscopy Procedures (PPMP) 33D2275238
Great Lakes Physician Practice Ob-Gyn · Jamestown, 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 Practice PC's NPI number?
The NPI number for Great Lakes Physician Practice PC is 1730599176. It was assigned to this organization in the NPPES registry on May 7, 2014.
Where is Great Lakes Physician Practice PC located?
Great Lakes Physician Practice PC is located at 15 S Main St, Jamestown, NY 14701. The listed phone number is (716) 488-1877.
What is Great Lakes Physician Practice PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Great Lakes Physician Practice PC enrolled in Medicare?
Yes. Great Lakes Physician Practice PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Lakes Physician Practice PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 234 clinicians in 29 Medicare specialties reassign their Medicare billing to Great Lakes Physician Practice 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 Nurse Practitioner (42), Internal Medicine (37) and Emergency Medicine (28). Of these, 32 practice at this address and 81 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Great Lakes Physician Practice PC hold CLIA laboratory certificates?
Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Great Lakes Physician Practice PC was last updated on February 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 Practice Pc · NPI 1730599176
Internal Medicine organization in Jamestown, New York. Organization record, active in the CMS NPPES registry since May 7, 2014.
## Identity
- **NPI:** 1730599176 (Entity type: Organization)
- **Enumerated:** May 7, 2014
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Patricia Devlin, SR.DIRECTOR
## Practice location
- **Address:** 15 S MAIN ST, Jamestown, NY 14701-6626
- **Phone:** (716) 488-1877 · **Fax:** (716) 488-1986
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 234 clinicians in 29 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (42), Internal Medicine (37), Emergency Medicine (28); 32 practice at this address and 81 within 10 miles; [full list](https://npiprofile.com/npi/1730599176/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 3, 2020
- **CLIA laboratory certificates:** 3 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1730599176) · Data from the CMS NPPES public registry.