Individual provider Active NPI

Kelly Rogers, DPM

  • Foot & Ankle Surgery Podiatrist
  • Olean, NY
National Provider Identifier
1174083125
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC007237 Issued in PA
Practice address
535 Main St
Olean, NY 14760-1500
Phone
(716) 376-2282
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X SC007237 PA Primary

Addresses

Primary practice location

535 Main St
Olean, NY 14760-1500

Mailing address

535 Main St Ste 1
Olean, NY 14760-1593

Other practice location 1

27050 Cedar Rd Apt 409
Beachwood, OH 44122-1125
Phone (206) 697-7077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220624001671 NY Practitioner - Podiatry 8527447309 Reassigns benefits to 1 organization
I20230524000447 PA Practitioner - Podiatry 8527447309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olean Medical Practice PLLCGroup PAC ID 0042698045, 56 clinicians

Practice addresses (Care Compare)

535 Main St
Olean, NY 14760-1500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue108
Removal of skin lesions13
Removal of nail tissue481
Removal or shaving of skin growth186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007128NYMDAcupuncturist
SC007237PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Sep 21, 2022 Accepting new patients
Olean Medical Practice PLLC Current Accepting new patients
General Physician, PC CurrentSince Sep 21, 2022 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

10 Timberview Ln
Russell, PA 16345
Phone (716) 376-2203

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658620800000",
    "number": "1174083125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MAIN ST STE 1",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500",
            "telephone_number": "716-376-2282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27050 Cedar Rd Apt 409",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441221125",
            "country_code": "US",
            "telephone_number": "206-697-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KELLY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC007237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.