Kelly Alice Emerson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

032417 Issued in NY

Practice address

77 Goodell St Ste 340
Buffalo, NY 14203-1243

Phone

(716) 645-9715

NPI assigned

Jun 1, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  Medicare reassignment
• Ub Family Medicine, Inc

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  NPD

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

{
    "created_epoch": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1265273635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7823 HAYES HOLLOW RD",
            "city": "COLDEN",
            "state": "NY",
            "postal_code": "140339776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GOODELL ST STE 340",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031243",
            "telephone_number": "716-645-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "KELLY",
        "middle_name": "ALICE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Embassy Capital Group, LLC.
• Ember Nutrition Wellness
• Mary Ellen Emborsky, DO
• Omoadoni Diana Emeagui, M.D
• Claudia J Emerson, NP
• Robin B Emerson, LPN
• Onalee Emery
• Jill M Emhof, MSOTR/L
• Lisa Marie Emiliani, PHARM.D.
• Emily Hunt, NP in Psychiatry, PLLC

• Physician Assistant in Buffalo, NY
• Providers in Buffalo, 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 Aug 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.