Canalside Primary Care PC
NPI 1174651046 · Family Medicine Physician · North Tonawanda, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Canalside Primary Care PC is a Family Medicine Physician organization in North Tonawanda, NY (NPI 1174651046).
Provider details
- NPI number
- 1174651046
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lynne Ross, Owner(716) 690-2001
- License
- 229399 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Lynne Ross MD PC
Registry dates
- Enumerated
- 2007-03-01
- Last updated
- 2019-12-26
- Certified
- 2019-12-26
Frequently asked questions
- What is Canalside Primary Care PC's NPI number?
- Canalside Primary Care PC's National Provider Identifier (NPI) is 1174651046, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Canalside Primary Care PC?
- Canalside Primary Care PC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Canalside Primary Care PC located?
- Canalside Primary Care PC's practice location on file with NPPES is 43 Niagara St, North Tonawanda, NY 14120-6115.
- What is Canalside Primary Care PC's phone number?
- The practice phone number listed in the NPPES registry for Canalside Primary Care PC is (716) 690-2001.
- Does Canalside Primary Care PC accept Medicare?
- Canalside Primary Care PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Canalside Primary Care PC?
- The authorized official listed on Canalside Primary Care PC's NPPES record is Lynne Ross, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Canalside Primary Care PC's NPI active?
- Yes — Canalside Primary Care PC's NPI (1174651046) is active in the NPPES registry as of the last update on 2019-12-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.