LIUBOU SIMONOVICH (NPI# 1376942425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376942425 |
| Entity Type | Individual |
| Full Name | LIUBOU SIMONOVICH |
| Credential | PA |
| Practice Address |
2950 Elmwood Ave Kenmore NY 14217-1304 |
| Mailing Address |
67 Empress Ave Amherst NY 14226-1507 |
| Practice Telephone | 7166490887 |
| Practice Fax Number | 7166464611 |
| Mailing Telephone | 7169094710 |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2019-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2950 ELMWOOD AVE |
| City | KENMORE |
| State | NY |
| Zip Code | 14217-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734066 | Victoria Paulsen | Anesthesiology | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-06-16 |
| 1659909752 | Kenmore Mercy Hospital | Internal Medicine | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-04-01 |
| 1962048793 | David Michael Armstrong | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-11-27 |
| 1790332443 | Theresa Lynn Jackson | Dietitian, Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-08-19 |
| 1174058549 | Great Lakes Locums LLC | Hospitalist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2017-04-24 |
| 1619424884 | Buffalo Niagara Hospitalist LLC | General Acute Care Hospital | 2950 Elmwood Ave, Kenmore, NY 14217 | 2016-09-06 |
| 1629525167 | Caitlin Elizabeth Ortiz | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2016-09-01 |
| 1255714762 | Krystal R Burns | Nurse Anesthetist, Certified Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-07-01 |
| 1033591342 | Robert E Baker IIi | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-06-23 |
| 1295114601 | Jeffrey Olek | Pharmacist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585201 | Emma Rae Rooney | Student in an Organized Health Care Education/Training Program | 2900 Delaware Ave., Kenmore, NY 14217 | 2019-12-11 |
| 1558801530 | Elizabeth Fazio | Local Education Agency (LEA) | 3767 Delaware Ava, Kenmore, NY 14217 | 2017-02-24 |
| 1477940393 | Laura Sabia | Case Manager/Care Coordinator | 2900 Deleware Avenue, Kenmore, NY 14217 | 2015-04-17 |
| 1770994881 | Kenmore Family Medicine | Family Medicine | 2914 Elmwood Avenue, Kenmore, NY 14217 | 2014-05-12 |
| 1144576265 | Elizabeth Anne Leiser | Nurse Practitioner | 274 W Girard Blvd, Kenmore, NY 14217 | 2012-07-26 |
| 1730442385 | Christopher Landeo | Case Manager/Care Coordinator | 2900 Delaware Avenue, Kenmore, NY 14217 | 2012-06-19 |
| 1013291095 | Sharon Karnyski | Physical Therapist | 2900 Delaware Avenu, Kenmore, NY 14217 | 2011-10-07 |
| 1164706784 | Joanne Karen Cascio | Registered Nurse | 3756 Delaware Avenue, Kenmore, NY 14217 | 2011-09-30 |
| 1467742692 | Nicole Anne Perrotta | Occupational Therapy Assistant | 3767 Delaware Avenue, Kenmore, NY 14217 | 2011-04-08 |
| 1538466511 | Diane J. Sutter, M.d., LLC | Obstetrics & Gynecology | 3800 Delaware Avenue, Suite 102, Kenmore, NY 14217 | 2011-02-28 |
| Find all providers in zip 14217 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252005 | Kelly E Farrell | Physician Assistant | 2950 Elmwood Ave # A1, Kenmore, NY 14217-1304 | 2020-07-20 |
| 1265997191 | Kourtney Lenea Waggoner | Physician Assistant | 2950 Elmwood Ave Ste A1, Kenmore, NY 14217-1304 | 2019-02-05 |
| 1134671878 | James Patrick Goode | Physician Assistant | 246 Coventry Road, Kenmore, NY 14217-1136 | 2016-10-28 |
| 1528598067 | Catherine Jessica Barton | Physician Assistant | 2075 Sheridan Dr, Kenmore, NY 14223-1425 | 2017-06-18 |
| 1033591342 | Robert E Baker IIi | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-06-23 |
| 1689989907 | Donald G Busse Jr. | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2010-08-11 |
| 1962608505 | Valerie Colangelo | Physician Assistant | Kenmore Mercy Hospital, 2950 Elmwood Ave., Kenmore, NY 14217-1304 | 2007-06-21 |
| 1639113129 | Elizabeth Certo | Physician Assistant | 2914 Elmwood Ave, Kenmore, NY 14217-1332 | 2006-06-15 |
| 1386681609 | Joseph R. Oddo | Physician Assistant | 2949 Elmwood Ave, 203, Kenmore, NY 14217-1356 | 2006-06-02 |
| 1477513034 | Jessica Elise Brown | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217 | 2006-03-27 |
| Find all providers in KENMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.