Individual provider Active NPI

Kalifala Fane

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1275365884
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3980 Sheridan Dr
Amherst, NY 14226-1727
Phone
(716) 250-2000
Fax
(716) 250-2040
NPI assigned
Aug 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3980 Sheridan Dr
Amherst, NY 14226-1727

Mailing address

3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 250-2000

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
I20250207002877 NY Practitioner - Physician Assistant 1456891647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dent Neurologic Group LLPGroup PAC ID 1951298033, 117 clinicians

Practice addresses (Care Compare)

3980 Sheridan Dr
Amherst, NY 14226-1727
Phone (716) 250-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033030NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics Physician Assistant CurrentSince Aug 26, 2024 Accepting new patients
North Iowa Mercy Clinics CurrentSince Aug 26, 2024 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
Dent Neuologic Institute Past Accepting new patients

Locations

250 S Crescent Dr
Mason City, IA 50401
Phone (541) 422-6588

Interoperability endpoints

  • Direct secure messaging: kalifala.fane@dent.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHBEAA

Organizations & group practices 5

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": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1275365884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-250-2000",
            "fax_number": "716-250-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261727",
            "telephone_number": "716-250-2000",
            "fax_number": "716-250-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANE",
        "first_name": "KALIFALA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.