Individual provider Active NPI

Karley Renee McCarthy Kennedy

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1417823196
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1001 Main St FL 5
Buffalo, NY 14203-1009
Phone
(716) 323-0225
Fax
(716) 323-0293
NPI assigned
Oct 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2025

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 Primary

Addresses

Primary practice location

1001 Main St FL 5
Buffalo, NY 14203-1009

Mailing address

1001 Main St FL 5
Buffalo, NY 14203-1009
Phone (716) 323-0225

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
I20251211000516 NY Practitioner - Physician Assistant 8224522826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1001 Main St
FL 5
Buffalo, NY 14203-1009

1001 Main St
FL 5
Buffalo, NY 14203-1013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034816NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University at Buffalo Pediatric Associates Inc CurrentSince Jan 15, 2026 Accepting new patients
General Physician, PC Past Accepting new patients

Locations

1404 Sweet Home Rd
Ste 5
Amherst, NY 14228
Phone (716) 639-9360

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1417823196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0225",
            "fax_number": "716-323-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0225",
            "fax_number": "716-323-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KARLEY",
        "middle_name": "RENEE MCCARTHY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-11",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.