Individual provider Active NPI

Kristen Lynn Smyers, M.D.

  • Gynecology Physician
  • Niagara Falls, NY
National Provider Identifier
1063652972
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
260229 Issued in NY
Practice address
10175 Niagara Falls Blvd Ste 1
Niagara Falls, NY 14304-2941
Phone
(716) 205-0170
Fax
(716) 298-0956
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 260229 NY Primary

Addresses

Primary practice location

10175 Niagara Falls Blvd Ste 1
Niagara Falls, NY 14304-2941

Mailing address

136 Maple Rd
Williamsville, NY 14221-2922
Phone (716) 815-2400

Other practice location 1

9097 Main St
Clarence, NY 14031-1965
Phone (716) 205-0170

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000576 NY Practitioner - Obstetrics/Gynecology 8224206271

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Buffalo School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

136 Maple Rd
Williamsville, NY 14221-2922
Phone (716) 815-2400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Nov 1, 2020 Accepting new patients
Legacy Gynecology PLLC Gynecology CurrentSince Nov 1, 2020 Accepting new patients

Locations

9097 Main St
Clarence, NY 14031
Phone (716) 222-0297

6440 Transit Rd
Depew, NY 14043
Phone (716) 684-5454

10175 Niagara Falls Blvd
#1
Niagara Falls, NY 14304
Phone (716) 205-0170

136 Maple Rd
Williamsville, NY 14221
Phone (716) 632-8124

Interoperability endpoints

  • Direct secure messaging: ksmyers@legacygynecology.medentdirect.com

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": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1063652972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212922",
            "telephone_number": "716-815-2400",
            "fax_number": "716-242-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 NIAGARA FALLS BLVD STE 1",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143042941",
            "telephone_number": "716-205-0170",
            "fax_number": "716-298-0956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9097 Main St",
            "address_purpose": "LOCATION",
            "city": "Clarence",
            "state": "NY",
            "postal_code": "140311965",
            "country_code": "US",
            "telephone_number": "716-205-0170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMYERS",
        "first_name": "KRISTEN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "260229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.