Kourtney Lenea Waggoner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

023195 Issued in NY

Practice address

2950 Elmwood Ave Ste A1
Kenmore, NY 14217-1304

Phone

(716) 529-3070

Fax

(716) 529-3071

NPI assigned

Feb 5, 2019

Sex

Female

Sole proprietor

No

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, IL, MI, IN, PA5 enrollments

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 5

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89 of 100Reported as group

Quality

76.13

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  PA

  Medicare reassignment Care Compare group
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment NPD
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890

  MI

  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385
  NPD (past)

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1265997191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 UNION RD STE 218",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254251",
            "telephone_number": "716-206-1503",
            "fax_number": "716-651-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE STE A1",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-529-3070",
            "fax_number": "716-529-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "KOURTNEY",
        "middle_name": "LENEA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandrea Verost, AUD
• Caitlin Vigliotti
• Joseph Salvatore Vilardo, D.D.S.
• Nicole Vallio Volz
• Natalie Waddell
• David Michael Walborn, MD
• Kelsey M Walck, PT, DPT
• Ebone Alexis Walcott
• Walgreen Co
• Cherrise Walker-Betts

• Physician Assistant in Kenmore, NY
• Providers in Kenmore, 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 Feb 5, 2019; 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.