Individual provider Active NPI

Colin David Kalabanka, DPM

  • Student in an Organized Health Care Education/Training Program
  • Buffalo, NY
National Provider Identifier
1083291678
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2157 Main St
Buffalo, NY 14214-2692
Phone
(716) 862-1000
NPI assigned
Mar 28, 2021
Last updated
Mar 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2692

Mailing address

5904 E Lake Rd
Auburn, NY 13021-9612
Phone (315) 406-5030

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904003078 NY Practitioner - Podiatry 3779023825 Reassigns benefits to 2 organizations
Practice locations: Auburn, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan Damico DPM PLLCGroup PAC ID 0345485421, 5 clinicians

Practice addresses (Care Compare)

514 S Bay Rd
North Syracuse, NY 13212-3627
Phone (315) 458-1777

7075 Manlius Ctr Rd
East Syracuse, NY 13057-2607
Phone (315) 446-3668

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue62
Removal of skin lesions47
Removal of nail tissue1041
Removal or shaving of skin growth673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007411NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Services of Central New York, PC CurrentSince Aug 19, 2024 Accepting new patients
Ryan D'Amico DPM PLLC CurrentSince Mar 23, 2026 Accepting new patients
Podiatry Services of Central New York P C CurrentSince Aug 19, 2024 Accepting new patients

Locations

171 Grant Ave
Auburn, NY 13021
Phone (315) 255-0070

15 E Genesee St
Baldwinsville, NY 13027
Phone (518) 312-7477

4912 W Genesee St
Camillus, NY 13031
Phone (315) 487-2631

7075 Manlius Center Rd
East Syracuse, NY 13057
Phone (315) 446-3668

61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274

514 S Bay Rd
Syracuse, NY 13212
Phone (315) 458-1777

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1083291678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 E LAKE RD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219612",
            "telephone_number": "315-406-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142692",
            "telephone_number": "716-862-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALABANKA",
        "first_name": "COLIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.