Individual provider Active NPI

Kelly Marie Cardamone, MS, RD, CDN, CDE

  • Registered Dietitian
  • Buffalo, NY
National Provider Identifier
1417120833
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
48006465 Issued in NY
Practice address
191 Starin Ave
Buffalo, NY 14214-1552
Phone
(716) 523-2398
NPI assigned
Apr 7, 2008
Last updated
Feb 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 48006465 NY Primary

Addresses

Primary practice location

191 Starin Ave
Buffalo, NY 14214-1552

Mailing address

191 Starin Ave
Buffalo, NY 14214-1552
Phone (716) 523-2398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000451 NY Practitioner - Registered Dietitian Or Nutrition Professional 3779742952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

705 Maple Rd
Williamsville, NY 14221-3291
Phone (716) 656-4077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
48006465NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jun 4, 2018 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

1091 Main St
Ste 301GP
Buffalo, NY 14209

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

705 Maple Rd
Williamsville, NY 14221
Phone (716) 580-7300

Interoperability endpoints

  • Direct secure messaging: kcardamone@gppc.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1417120833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 STARIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142141552",
            "telephone_number": "716-523-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 STARIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142141552",
            "telephone_number": "716-523-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDAMONE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "48006465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.