Individual provider Active NPI

Kelly Walsh

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1346629557
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088314-1 Issued in NY
Practice address
3020 Bailey Ave
Buffalo, NY 14215-2814
Phone
(716) 831-2700
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 088314-1 NY Primary

Addresses

Primary practice location

3020 Bailey Ave
Buffalo, NY 14215-2814

Mailing address

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190621002689 NY Practitioner - Clinical Social Worker 0143554386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Health Services IncGroup PAC ID 5698689925, 144 clinicians

Practice addresses (Care Compare)

699 Hertel Ave
Suite 350
Buffalo, NY 14207-2341
Phone (716) 831-1977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088314-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Services Inc CurrentSince May 13, 2019 Accepting new patients

Locations

699 Hertel Ave
Ste 350
Buffalo, NY 14207
Phone (716) 831-1977

3020 Bailey Ave
Cheektowaga, NY 14215
Phone (716) 831-0200

55 Dodge Rd
Getzville, NY 14068
Phone (716) 650-5100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 1

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": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1346629557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-831-2700",
            "fax_number": "716-831-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142152814",
            "telephone_number": "716-831-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088314-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.