Kelly Kaczor, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4955 N Bailey Ave Ste 202
Amherst, NY 14226-1206

Phone

(716) 832-8500

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul R Young MD PLLCGroup PAC ID 6709013378, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Paul R. Young MD PLLC

  • Otolaryngology Physician
  • Amherst, NY
  • NPI 1245675669
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1104355973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 N BAILEY AVE STE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261206",
            "telephone_number": "716-832-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 N BAILEY AVE STE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261206",
            "telephone_number": "716-832-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZOR",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph R. Berardi, MD PC
• Claire Joshi
• Joyful Journey Mental Health Counseling PLLC
• Julie Stumpff NP Adult Health PLLC
• Kellie Kabza, MS OTR/L
• Ali Kadhum
• Kevin W Kaempf, RPH
• Ashley Ann Kaetzel, MS, OTR/L
• Julia Kagan, DDS
• Elena Kalabushkina

• Physician Assistant in Amherst, NY
• Providers in Amherst, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; 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.

Verify at the official NPI Registry.