Kassidy Baniak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

315 S Manning Blvd
Albany, NY 12208-1789

Phone

(518) 242-0880

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbaniak3499805@direct.trinity-health.org

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.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment Care Compare group
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Physician Assistant

  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1235970583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081789",
            "telephone_number": "518-242-0880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Nott St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082425",
            "country_code": "US",
            "telephone_number": "518-242-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANIAK",
        "first_name": "KASSIDY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Bandovic, DO
• Aaron Francis Banewicz
• Lori Banfield, PT
• Christopher S. Bang, D.O.
• Natasha Conover Bang, LMSW
• David Anthony Banker, M.ED.
• Zonnita R Banks, LCSW
• Howard Banner, D.D.S.
• Christopher Bannigan
• Amy Bannon, PT

• Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.