Individual provider Active NPI

Shannon Kaempffe, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Hornell, NY
National Provider Identifier
1194379248
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
024233 Issued in NY
Practice address
111 Loder St
Hornell, NY 14843-1950
Phone
(315) 412-1117
NPI assigned
Jul 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024233 NY
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 024233 NY Primary

Addresses

Primary practice location

111 Loder St
Hornell, NY 14843-1950

Mailing address

300 Residence Way Apt 305
Hornell, NY 14843-9190
Phone (315) 412-1117

Other practice location 1

2209 Genesee St
Utica, NY 13501-5930
Phone (315) 801-8100

Other practice location 2

1656 Champlin Ave
Utica, NY 13502-4830
Phone (315) 624-6000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023003026 NY Practitioner - Physician Assistant 3274865241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 W Ave
Brockport, NY 14420-1118
Phone (716) 637-3905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024233NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Orchard Community Health Center Inc. CurrentSince Feb 2, 2026 Accepting new patients
Oak Orchard Community Health Center Inc CurrentSince Feb 2, 2026 Accepting new patients

Locations

300 West Ave
Brockport, NY 14420
Phone (585) 637-3905

7309 Seneca Rd N
Ste 112
Hornell, NY 14843
Phone (607) 590-2424

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1564185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1194379248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RESIDENCE WAY APT 305",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148439190",
            "telephone_number": "315-412-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LODER ST",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148431950",
            "telephone_number": "315-412-1117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 Genesee St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135015930",
            "country_code": "US",
            "telephone_number": "315-801-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1656 Champlin Ave",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135024830",
            "country_code": "US",
            "telephone_number": "315-624-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAEMPFFE",
        "first_name": "SHANNON",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-27",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024233",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "024233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hornell, NY

Sources for this page

Verify at the official NPI Registry.