Individual provider Active NPI

Allison K Kennedy

  • Physician Assistant
  • Lackawanna, NY
National Provider Identifier
1467383752
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
790 Ridge Rd
Lackawanna, NY 14218-1629
Phone
(716) 828-7586
Fax
(716) 828-7589
NPI assigned
May 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

790 Ridge Rd
Lackawanna, NY 14218-1629

Mailing address

790 Ridge Rd
Lackawanna, NY 14218-1629
Phone (716) 828-7586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

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

Practice addresses (Care Compare)

171 Sullys TRL
Pittsford, NY 14534-4557

790 Ridge Rd
Lackawanna, NY 14218-1696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1779753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1467383752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 RIDGE RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181629",
            "telephone_number": "716-828-7586",
            "fax_number": "716-828-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 RIDGE RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181629",
            "telephone_number": "716-828-7586",
            "fax_number": "716-828-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ALLISON",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-26",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

Verify at the official NPI Registry.