Individual provider Active NPI

Kaylan Michelle Mayo, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1003653619
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032358 Issued in NY
Practice address
3297 Bailey Ave
Buffalo, NY 14215-1139
Phone
(716) 847-2441
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 032358 NY Primary

Addresses

Primary practice location

3297 Bailey Ave
Buffalo, NY 14215-1139

Mailing address

206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone (716) 847-2441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821003121 NY Practitioner - Physician Assistant 1456899418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehs, IncGroup PAC ID 7618946310, 41 clinicians
Community Health Center of Buffalo IncGroup PAC ID 8527052265, 15 clinicians

Practice addresses (Care Compare)

206 S Elmwood Ave
Buffalo, NY 14201-2398
Phone 71684724411716

34 Benwood Ave
Buffalo, NY 14214-1761
Phone (716) 986-9199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
032358NYMDPhysical Therapist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDJFBA/Endpoint/HDJFBA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1003653619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012398",
            "telephone_number": "716-847-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151139",
            "telephone_number": "716-847-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "KAYLAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.