Active NPI
Kathleen Speta, FNP
- Family Nurse Practitioner
- Wellsville, NY
National Provider Identifier
1083970529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F3370711
- Practice address
- 15 Loder St
191 North Main Street
Wellsville, NY 14895-1112 - Phone
- (585) 596-4129
- Fax
- (585) 596-0653
- NPI assigned
- Apr 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | F3370711 | NY | |
| Family Nurse Practitioner | 363LF0000X | F3370711 | NY | Primary |
Addresses
Primary practice location
15 Loder St
191 North Main Street
Wellsville, NY 14895-1112
Mailing address
256 Center Rd
West Seneca, NY 14224-1947
Phone (716) 677-4159
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120911000002 | NY | Practitioner - Nurse Practitioner | 7810145265 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Academic Medicine Services, Inc.
Practice addresses (Care Compare)
3018 Military Rd
Niagara Falls, NY 14304-1225
Phone (716) 298-4195
462 Grider St
Buffalo, NY 14215-3021
550 Orchard Park Rd
West Seneca, NY 14224-2646
Phone (800) 424-6589
Hospital & facility affiliations
- Sisters of Charity Hospital
- Erie County Medical Center
- Kaleida Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3370711 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Academic Medicine Services, Inc. | Current | Accepting new patients | |
| David S. Clifford, MD | Past | Accepting new patients |
Locations
462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803
462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612
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.
-
- Family Medicine Physician
- West Seneca, NY
- NPI 1134591019
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1437197985
Hospital
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
Hospital
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1790727543
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1083970529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "256 CENTER RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142241947",
"telephone_number": "716-677-4159",
"fax_number": "716-677-4470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 LODER ST",
"address_2": "191 NORTH MAIN STREET",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148951112",
"telephone_number": "585-596-4129",
"fax_number": "585-596-0653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPETA",
"first_name": "KATHLEEN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-10",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "NY",
"license": "F3370711",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F3370711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wellsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.