Individual provider Active NPI

Allyson Laetita Kirk, RPA-C

  • Physician Assistant
  • Amherst, NY
National Provider Identifier
1407852973
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006458-1 Issued in NY
Practice address
500 Corporate Pkwy
Suite 100
Amherst, NY 14226-1263
Phone
(716) 631-0380
Fax
(716) 631-3229
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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 006458-1 NY Primary

Addresses

Primary practice location

500 Corporate Pkwy
Suite 100
Amherst, NY 14226-1263

Mailing address

500 Corporate Pkwy
Suite 100
Amherst, NY 14226-1263
Phone (716) 631-0380

Other identifiers 1

IdentifierTypeStateIssuer
02504929MedicaidNY

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
I20040109000343 NY Practitioner - Physician Assistant 4284539107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Jeanne Lomas Allergy Medicine PLLCGroup PAC ID 0042745317, 7 clinicians

Practice addresses (Care Compare)

500 Corporate Pkwy
Suite 100
Amherst, NY 14226-1263
Phone (716) 631-0380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006458-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC PastSince Apr 1, 2016 Accepting new patients
Frederick M. Occhino, D.O.,P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: allysonkirkrpa-c@baaa.medentdirect.com

Organizations & group practices 3

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1407852973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CORPORATE PKWY",
            "address_2": "SUITE 100",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261263",
            "telephone_number": "716-631-0380",
            "fax_number": "716-631-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CORPORATE PKWY",
            "address_2": "SUITE 100",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261263",
            "telephone_number": "716-631-0380",
            "fax_number": "716-631-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ALLYSON",
        "middle_name": "LAETITA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006458-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02504929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.