Individual provider Active NPI

Kaitlyn Marie Lipka, PA-C

  • Medical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1225632789
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
100 High St
Buffalo, NY 14203-1126
Phone
(716) 859-3317
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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 NY Primary

Addresses

Primary practice location

100 High St
Buffalo, NY 14203-1126

Mailing address

2998 Cloverbank Rd
Hamburg, NY 14075-3432
Phone (716) 713-9734

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
I20210216000966 NY Practitioner - Physician Assistant 0648685164 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025563NYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: kaitlyn.lipka.p1@direct.wnyrheum.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1225632789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2998 CLOVERBANK RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753432",
            "telephone_number": "716-713-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPKA",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.