Canalside Primary Care PC
NPI 1174651046ActiveOrganization· Family Medicine· North Tonawanda, NY
Family Medicine in North Tonawanda, New York, registered in NPPES in March 2007. The authorized official on file is Lynne Susan Ross, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174651046 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 1, 2007 |
| Last updated in NPPES | Dec 26, 2019 |
| Certified by provider | Dec 26, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 229399 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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