Individual provider Active NPI

Kelly McLean, FNP-C

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1063804920
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344322 Issued in NY
Practice address
564 Niagara St
Buffalo, NY 14201
Phone
(716) 882-0366
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 633253 NY
Family Nurse Practitioner 363LF0000X 344322 NY Primary

Addresses

Primary practice location

564 Niagara St
Buffalo, NY 14201

Mailing address

564 Niagara St
Buffalo, NY 14201-1108
Phone (716) 882-0366

Other practice location 1

1315 Jefferson Ave
Buffalo, NY 14208-2102
Phone (716) 332-3797

Other practice location 2

564 Niagara St
Buffalo, NY 14201
Phone (716) 882-0366

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
I20190731000919 NY Practitioner - Nurse Practitioner 0345576153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care Medical Practice PLLCGroup PAC ID 5991199804, 25 clinicians

Practice addresses (Care Compare)

564 Niagara St
BLDG 2
Buffalo, NY 14201-1108
Phone (716) 882-0366

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
633253NYMDRegistered Nurse
344322NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Practice PLLC Family CurrentSince Jul 1, 2022 Accepting new patients
Urban Family Practice PC Family CurrentSince Jul 2, 2019 Accepting new patients

Locations

2300 N St NW
Ste 200
Washington, DC 20037
Phone (844) 401-4663

322 Linden Blvd
Brooklyn, NY 11226
Phone (718) 230-7788

564 Niagara St
Buffalo, NY 14201
Phone (716) 768-7700

564 Niagara St
Bldg 2
Buffalo, NY 14201
Phone (716) 324-5026

1315 Jefferson Ave
Buffalo, NY 14208
Phone (716) 332-3797

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: kelly.mclean@cinq-nyipa.medentdirect.com
  • Direct secure messaging: kelly.mclean@caremedicalpractice.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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1063804920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142011108",
            "telephone_number": "716-882-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14201",
            "telephone_number": "716-882-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142082102",
            "country_code": "US",
            "telephone_number": "716-332-3797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "564 Niagara St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "14201",
            "country_code": "US",
            "telephone_number": "716-882-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "633253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.