NPIMap

Individual provider Active NPI

Kellie N Schwartz, PA-C

  • Medical Physician Assistant
  • Williamsville, NY
National Provider Identifier
1184681090
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
010928 Issued in NY
Practice address
400 International Dr
Williamsville, NY 14221-5771
Phone
(716) 631-3555
Fax
(716) 631-9525
NPI assigned
Apr 26, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 010928 NY Primary

Addresses

Primary practice location

400 International Dr
Williamsville, NY 14221-5771

Mailing address

400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555

Other identifiers 1

IdentifierTypeStateIssuer
9513121OtherNYINDEPENDENT HEALTH

Other names 1

  • Kellie N McGranor Former name

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
I20060228000562 NY Practitioner - Physician Assistant 0345256319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

400 International Dr
Buffalo, NY 14221-5760

400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
010928NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Spine Medical Services PLLC CurrentSince Jan 13, 2006 Accepting new patients
David L. Bagnall MD PC Past Accepting new patients

Locations

400 International Dr
Williamsville, NY 14221
Phone (716) 631-1516

Interoperability endpoints

  • Direct secure messaging: kschwartz@invisionhealthbrainandspine.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 8

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1184681090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "KELLIE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9513121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "MCGRANOR",
            "middle_name": "N",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.