Lake Shore Audiology, P C is a medicare enrolled "Audiologist-hearing Aid Fitter" provider in Orchard Park, New York. Their current practice location is
3085 Southwestern Blvd Ste 103, Orchard Park, New York. You can reach out to their office (for appointments etc.) via phone at
(716) 674-4188.
Lake Shore Audiology, P C is licensed to practice in New York (license number 15000008841) and it also participates in the medicare program. Lake Shore Audiology, P C
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1811052939.
Healthcare Provider's Profile
| Full Name | Lake Shore Audiology, P C |
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| Type | Facility |
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| Speciality | Audiologist-hearing Aid Fitter |
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| Location | 3085 Southwestern Blvd Ste 103, Orchard Park, New York |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811052939
- Provider Enumeration Date: 12/27/2006
- Last Update Date: 12/01/2022
Medicare PECOS Information:
- PECOS PAC ID: 1850492406
- Enrollment ID: O20070807000462
Medical Identifiers
Medical identifiers for Lake Shore Audiology, P C such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811052939 | NPI | - | NPPES |
| 00011388701 | Other | | UNIVERA |
| 9210249 | Other | | INDEPENDENT HEALTH |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 231H00000X | Audiologist | 001421-2 (New York) | Secondary |
| 237600000X | Audiologist-hearing Aid Fitter | 15000008841 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Lake Shore Audiology, P C acts as a billing entity for following providers:
| Provider Name | Kevin G Flanagan |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1437190451
PECOS PAC ID: 5395836290
Enrollment ID: I20111215000596 |
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| Provider Name | Tara Bodziak |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1073036927
PECOS PAC ID: 9739452178
Enrollment ID: I20170906001818 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lake Shore Audiology, P C is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lake Shore Audiology, P C
849 Rt 5 & 20,
Irving, NY 14081
Ph: (716) 934-2025 | Lake Shore Audiology, P C
3085 Southwestern Blvd Ste 103,
Orchard Park, NY 14127-1234
Ph: (716) 674-4188 |
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