NPIMap

Individual provider Active NPI

Kathleen E Schiele, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Hamburg, NY
National Provider Identifier
1407850886
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002368-1 Issued in NY
Practice address
4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone
(716) 646-1084
Fax
(716) 646-0763
NPI assigned
Jun 13, 2005
Last updated
Aug 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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 002368-1 NY Primary

Addresses

Primary practice location

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600

Mailing address

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Other identifiers 6

IdentifierTypeStateIssuer
02933833MedicaidNY
141534BFOtherNYPREFERRED CARE
01275947MedicaidNY
000570020004OtherNYBC/BS
9511805OtherNYINDEPENDENT HEALTH
00026556202OtherUNIVERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000295 NY Practitioner - Physician Assistant 1153402870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Primary Care Associates, LLPGroup PAC ID 9931013703, 13 clinicians

Practice addresses (Care Compare)

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002368NYMDPsychologist
002368-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients
General Physician, PC PastSince Apr 1, 2016 Accepting new patients
Frederick M. Occhino, D.O.,P.C. Past Accepting new patients
Eric H. Goodwin MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kschiele@lakeshorepca.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1407850886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752600",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752600",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIELE",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002368-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02933833",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "141534BF",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01275947",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000570020004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9511805",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026556202",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.