Great Lakes Medical Imaging LLC
NPI 1861763005 · Diagnostic Radiology Physician · Williamsville, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Great Lakes Medical Imaging LLC is a Diagnostic Radiology Physician organization in Williamsville, NY (NPI 1861763005).
Provider details
- NPI number
- 1861763005
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kenneth Pearsen, MD(716) 836-4646
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
14 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
Registry dates
- Enumerated
- 2012-01-19
- Last updated
- 2023-08-21
- Certified
- 2023-08-21
Frequently asked questions
- What is Great Lakes Medical Imaging LLC's NPI number?
- Great Lakes Medical Imaging LLC's National Provider Identifier (NPI) is 1861763005, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Medical Imaging LLC?
- Great Lakes Medical Imaging LLC is classified in the NPPES registry as Diagnostic Radiology Physician (Allopathic & Osteopathic Physicians).
- Where is Great Lakes Medical Imaging LLC located?
- Great Lakes Medical Imaging LLC's practice location on file with NPPES is 111 N Maplemere Rd Ste 120, Williamsville, NY 14221-3178.
- What is Great Lakes Medical Imaging LLC's phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Medical Imaging LLC is (716) 836-4646.
- Does Great Lakes Medical Imaging LLC accept Medicare?
- Great Lakes Medical Imaging LLC 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 Great Lakes Medical Imaging LLC?
- The authorized official listed on Great Lakes Medical Imaging LLC's NPPES record is Kenneth Pearsen, MD. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Medical Imaging LLC's NPI active?
- Yes — Great Lakes Medical Imaging LLC's NPI (1861763005) is active in the NPPES registry as of the last update on 2023-08-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.