Individual provider Active NPI

Khalid Salem Kakish, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Buffalo, NY
National Provider Identifier
1093009680
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
274222 Issued in NY
Practice address
5851 Main St
Buffalo, NY 14221-8208
Phone
(716) 932-6080
NPI assigned
Jun 1, 2011
Last updated
Nov 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 274222 NY
Neurology Physician 2084N0400X 274222 NY
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 274222 NY Primary

Addresses

Primary practice location

5851 Main St
Buffalo, NY 14221-8208

Mailing address

5851 Main St
Williamsville, NY 14221-5799
Phone (716) 932-6080

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
I20140818001601 NY Practitioner - Pediatric Medicine 8628295425 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274222NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health CurrentSince Nov 1, 2014 Accepting new patients
Kaleida Health Current Accepting new patients
University Neurology, Inc. Neurology CurrentSince Jul 1, 2014 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
Kaleida Health CurrentSince Nov 1, 2014 Accepting new patients
Western New York Licensed Clinical Social Work Services, PLLC PastSince Apr 24, 2023 Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

665 Elm St
Buffalo, NY 14203
Phone (716) 845-3389

77 Goodell St
Buffalo, NY 14203
Phone (716) 816-7258

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

5851 Main St
Williamsville, NY 14221
Phone (716) 632-3545

Interoperability endpoints

  • Direct secure messaging: khalidkakish@ubmd.allscriptsdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1093009680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215799",
            "telephone_number": "716-932-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142218208",
            "telephone_number": "716-932-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKISH",
        "first_name": "KHALID",
        "middle_name": "SALEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "274222",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "274222",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "274222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.