Individual provider Active NPI

Mitchell Kerner, ANP

  • Adult Health Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1356975940
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309551-01 Issued in NY
Practice address
100 College Pkwy Ste 110
Williamsville, NY 14221-6885
Phone
(716) 631-8863
NPI assigned
Feb 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309551-01 NY Primary

Addresses

Primary practice location

100 College Pkwy Ste 110
Williamsville, NY 14221-6885

Mailing address

10 Carriage Dr Apt 6
Orchard Park, NY 14127-1834
Phone (716) 860-0086

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
I20200403000196 NY Practitioner - Nurse Practitioner 4082043526 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Mount St. Mary'S Hospital & Health Center Hospital, Lewiston, NY, CCN 330188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F309551-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Group of Western New York, LLP CurrentSince Mar 16, 2020 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Jan 21, 2024 Accepting new patients
Rpci Oncology PC CurrentSince Aug 5, 2024 Accepting new patients
Saif Soniwala,M.D.,PC Current Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

100 College Pkwy
Ste 110
Williamsville, NY 14221
Phone (716) 631-8863

2699 Wehrle Dr
Williamsville, NY 14221
Phone (716) 631-8863

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: mkerner@breastcarewny.medentdirect.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1356975940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CARRIAGE DR APT 6",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271834",
            "telephone_number": "716-860-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY STE 110",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216885",
            "telephone_number": "716-631-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "MITCHELL",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309551-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.