Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Great Lakes Medical Imaging LLC

Diagnostic Radiology Physician in Williamsville, NY · enumerated 2012 · authorized official Kenneth Pearsen, MD.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1861763005

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Registry record

Entity type Organization (Type 2)

Legal business name Great Lakes Medical Imaging LLC

Practice address 111 N Maplemere Rd Ste 120, Williamsville, NY, 14221

Phone (716) 836-4646

Fax (716) 836-4696

Enumeration date Jan 19, 2012

Last updated in NPPES Aug 21, 2023

Taxonomy & classification

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Kenneth Pearsen

Title MD

Phone (716) 836-4646

Other identifiers

Identifier	Type	State	Issuer
03428622	Medicaid	NY	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-08-21. Verify at npiregistry.cms.hhs.gov.

Where is Great Lakes Medical Imaging LLC located?

The practice location on file with NPPES is in Williamsville, NY.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-08-21.