NPIMap

Individual provider Active NPI

Trudy M Kiah, RPAC

  • Physician Assistant
  • Ogdensburg, NY
National Provider Identifier
1083789515
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0071951 Issued in NY
Practice address
921 State St
Ogdensburg, NY 13669-3347
Phone
(315) 393-9269
Fax
(315) 393-3541
NPI assigned
Nov 21, 2006
Last updated
Oct 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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 0071951 NY Primary

Addresses

Primary practice location

921 State St
Ogdensburg, NY 13669-3347

Mailing address

921 State St
Ogdensburg, NY 13669-3347
Phone (315) 393-9269

Other identifiers 1

IdentifierTypeStateIssuer
01330116MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140724000457 NY Practitioner - Physician Assistant 4688768237 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians
Carthage Area Hospital IncGroup PAC ID 9931010485, 119 clinicians
River Hospital IncGroup PAC ID 2567372899, 36 clinicians
Ogdensburg Family Practice LLCGroup PAC ID 2365669249, 3 clinicians

Practice addresses (Care Compare)

100 Horwood PL
Ogdensburg, NY 13669-4510
Phone (315) 394-9462

4 Fuller St
Alexandria Bay, NY 13607-1391

921 State St
Ogdensburg, NY 13669-3347
Phone (315) 393-9268

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0071951NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Claxton Medical PC Physician Assistant CurrentSince Oct 25, 2015 Accepting new patients
Carthage Area Hospital Inc CurrentSince Apr 21, 2024 Accepting new patients
Carthage Area Hospital Inc. CurrentSince Apr 21, 2024 Accepting new patients

Locations

4 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1277

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

3 Lyon Pl
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ste 200
Ogdensburg, NY 13669
Phone (315) 394-7542

3 Lyon Pl
Ste 302
Ogdensburg, NY 13669
Phone (315) 393-7955

921 State St
Ogdensburg, NY 13669
Phone (315) 393-9268

Interoperability endpoints

  • Direct secure messaging: tkiah@cahclinics.medentdirect.com
  • Direct secure messaging: tkiah@hiemail.healtheconnections.org

Organizations & group practices 8

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 7

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1083789515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693347",
            "telephone_number": "315-393-9269",
            "fax_number": "315-393-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693347",
            "telephone_number": "315-393-9269",
            "fax_number": "315-393-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIAH",
        "first_name": "TRUDY",
        "middle_name": "M",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0071951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01330116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.