MEDICARE: DR. THOMAS ROBERT ELMER VI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	224822-2	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00225786	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161578122	OTHER	NY	EMPIRE - UNITED HEALTHCAR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	161578122	OTHER	NY	NOVA
4	161578122	OTHER	NY	AMERISIGHT
5	251744484	OTHER	NY	NOVA
6	161578122	OTHER	NY	NORTH AMERICAN PREFERRED
7	251744484	OTHER	NY	EMPIRE - UNITED HEALTHCAR
9	00011122301	OTHER	NY	UNIVERA
10	161578122	OTHER	NY	VISION LCA
11	251744484	OTHER	NY	NORTH AMERICAN PREFERRED

General Provider Information

NPI Number	:	1255335907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ROBERT ELMER VI MD

Provider Business Mailing Address
First Line	:	1837 WINTER RD
Second Line	:
City	:	GRAND ISLAND
State	:	NY
Zip	:	14072-1053
Country	:	US
Telephone Number	:	716-864-5479
Fax Number	:	716-564-2060

Provider Business Practice Location Address
First Line	:	2825 NIAGARA FALLS BLVD
Second Line	:	STE 130
City	:	AMHERST
State	:	NY
Zip	:	14228-2021
Country	:	US
Telephone Number	:	716-564-2020
Fax Number	:	716-564-2060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	06/01/2016

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