Active NPI
Kelsey Nicosia, PSYD
- Clinical Psychologist
- Buffalo, NY
National Provider Identifier
1164316071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 027293
- Practice address
- 400 Forest Ave
Buffalo, NY 14213-1207 - Phone
- (716) 816-2307
- NPI assigned
- Jun 5, 2025
- Last updated
- Jun 5, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 027293 | NY | Primary |
Addresses
Primary practice location
400 Forest Ave
Buffalo, NY 14213-1207
Mailing address
21 Banko Dr
Depew, NY 14043-1203
Phone (716) 341-2742
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250707003188 | NY | Order and Referring Only - Clinical Psychologist | 1658885256 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027293 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749081600000",
"number": "1164316071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 BANKO DR",
"city": "DEPEW",
"state": "NY",
"postal_code": "140431203",
"telephone_number": "716-341-2742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 FOREST AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142131207",
"telephone_number": "716-816-2307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOSIA",
"first_name": "KELSEY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-05",
"last_updated": "2025-06-05",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "027293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.