Individual provider Active NPI

Kurt Spencer Walburn, PA-C

  • Physician Assistant
  • Herkimer, NY
National Provider Identifier
1497384242
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026116 Issued in NY
Practice address
201 E State St
Herkimer, NY 13350-2389
Phone
(607) 398-4713
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 026116 NY Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

201 E State St
Herkimer, NY 13350-2389

Mailing address

10 Patriot Cir Apt B
Utica, NY 13502-1664

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
I20210512001350 NY Practitioner - Physician Assistant 5092124602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

201 E State St
Herkimer, NY 13350-2389
Phone (315) 717-0083

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026116NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince May 1, 2021 Accepting new patients
MVHS Inc CurrentSince May 1, 2021 Accepting new patients

Locations

201 E State St
Herkimer, NY 13350
Phone (315) 574-0026

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

120 Hobart St
Utica, NY 13501
Phone (315) 798-1149

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: kwalburn30861@mvhealthsystem.direct-ci.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 and National Provider Directory roles.

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1497384242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PATRIOT CIR APT B",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E STATE ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502389",
            "telephone_number": "607-398-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALBURN",
        "first_name": "KURT",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026116",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herkimer, NY

Sources for this page

Verify at the official NPI Registry.