Individual provider Active NPI

Kayla Ackerman, MD

  • Otolaryngology Physician
  • Oneida, NY
National Provider Identifier
1124525662
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
324310-01 Issued in NY
Practice address
221 Broad St Ste 201
Oneida, NY 13421-2178
Phone
(315) 363-5421
Fax
(315) 363-5472
NPI assigned
Apr 11, 2018
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 324310-01 NY Primary

Addresses

Primary practice location

221 Broad St Ste 201
Oneida, NY 13421-2178

Mailing address

221 Broad St Ste 201
Oneida, NY 13421-2178
Phone (315) 363-5421

Other names 1

  • Kayla Jasper Former name

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
I20230824000746 NY Practitioner - Otolaryngology 4183960255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
George Washington University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oneida Medical Practice PCGroup PAC ID 9830272350, 51 clinicians

Practice addresses (Care Compare)

221 Broad St-Attn ENT Specialists of
Suite 201
Oneida, NY 13421-2178
Phone (315) 363-5421

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324310-01NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oneida Medical Practice, PC CurrentSince Aug 1, 2023 Accepting new patients
Oneida Medical Practice, PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

221 Broad St
Ste 201
Oneida, NY 13421
Phone (315) 234-3842

301 Genesee St
Ste C
Oneida, NY 13421
Phone (315) 361-2377

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

Interoperability endpoints

  • Direct secure messaging: kackerman@ompohc.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1124525662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BROAD ST STE 201",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212178",
            "telephone_number": "315-363-5421",
            "fax_number": "315-363-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BROAD ST STE 201",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212178",
            "telephone_number": "315-363-5421",
            "fax_number": "315-363-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "KAYLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "324310-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "JASPER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oneida, NY

Sources for this page

Verify at the official NPI Registry.