NPIMap

Individual provider Active NPI

Kiel Clarke, DO

  • Family Medicine Physician
  • Niagara Falls, NY
National Provider Identifier
1174026728
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
311217 Issued in NY
Practice address
6950 Williams Rd
Niagara Falls, NY 14304-3025
Phone
(716) 297-1027
Fax
(716) 298-4081
NPI assigned
Mar 9, 2018
Last updated
Aug 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 311217 NY Primary

Addresses

Primary practice location

6950 Williams Rd
Niagara Falls, NY 14304-3025

Mailing address

6950 Williams Rd
Niagara Falls, NY 14304-3025
Phone (716) 297-1027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809001667 NY Practitioner - Family Practice 2668876921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarke Family Medicine LLPGroup PAC ID 5395083653, 3 clinicians

Practice addresses (Care Compare)

1801 Grand Island Blvd
Suite 300
Grand Island, NY 14072-2249
Phone (716) 297-1027

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke Family Medicine, LLP Family Medicine CurrentSince Jul 20, 2021 Accepting new patients

Locations

1801 Grand Island Blvd
Ste 300
Grand Island, NY 14072
Phone (716) 297-1027

6950 Williams Rd
Niagara Falls, NY 14304
Phone (716) 205-0773

Interoperability endpoints

  • Direct secure messaging: kclarke@clarke.medentdirect.com

Organizations & group practices 1

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 9

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": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1174026728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 WILLIAMS RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143043025",
            "telephone_number": "716-297-1027",
            "fax_number": "716-298-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 WILLIAMS RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143043025",
            "telephone_number": "716-297-1027",
            "fax_number": "716-298-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "311217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.