Active NPI
Kurtis Kiadum Suteh Kpajoh, DMSC, PA
- Physician Assistant
- Amherst, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 013091
- Practice address
- 3921 Harlem Rd
Amherst, NY 14226-4703 - Phone
- (716) 541-0550
- Fax
- (315) 741-0779
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 013091 | NY | Primary |
Addresses
Primary practice location
3921 Harlem Rd
Amherst, NY 14226-4703
Mailing address
3921 Harlem Rd
Amherst, NY 14226-4703
Phone (716) 541-0550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J400089155 | Other | NY | MEDICARE PTAN |
| 03047683 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1238 E Ridge Rd
Rochester, NY 14621-2012
Phone (585) 537-3792
1597 Elmwood Ave
Buffalo, NY 14207-3017
Phone (716) 262-3161
200 E 1St St
Oswego, NY 13126-2662
Phone (315) 207-7391
230 N Genesee St
Utica, NY 13502-2529
Phone (315) 275-3214
2980 Sheridan Dr
Tonawanda, NY 14150-9417
Phone (716) 262-3377
3190 Niagara Falls BVLD
Amherst, NY 14228-1639
Phone (716) 799-8190
3450 Union Rd
Cheektowaga, NY 14225-5120
Phone (716) 395-2043
3648 Dewey Ave
Rochester, NY 14616-3024
Phone (585) 786-3503
3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 929-2800
446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496
5965 Transit Rd
East Amherst, NY 14051-1874
Phone (716) 362-1093
6555 4TH Section Rd
Brockport, NY 14420-2441
Phone (585) 431-5364
7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellnow Urgent Care, PC | Past | Accepting new patients | |
| Wny Medical PC | Physician Assistant | Past | Accepting new patients |
| FDR Medical Services P.C. | Past | Accepting new patients |
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.
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
-
- Emergency Medicine Physician
- Williamsville, NY
- NPI 1528081809
-
- Urgent Care Clinic/Center
- Jamestown, NY
- NPI 1770850224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1255595138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3921 HARLEM RD",
"city": "AMHERST",
"state": "NY",
"postal_code": "142264703",
"telephone_number": "716-541-0550",
"fax_number": "315-741-0779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3921 HARLEM RD",
"city": "AMHERST",
"state": "NY",
"postal_code": "142264703",
"telephone_number": "716-541-0550",
"fax_number": "315-741-0779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTEH KPAJOH",
"first_name": "KURTIS KIADUM",
"name_prefix": "Dr.",
"credential": "DMSC, PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-10",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "013091",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "J400089155",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03047683",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Amherst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.