David A Kibby, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011985 Issued in NY

Practice address

5719 Widewaters Pkwy
Syracuse, NY 13214-1985

Phone

(315) 251-3100

Fax

(315) 449-9923

NPI assigned

May 24, 2007

Last updated

Nov 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Syracuse Orthopedic Specialists, PLLCGroup PAC ID 6406760073, 115 clinicians

Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkibby33407@direct.upstate.edu

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.

• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  Medicare reassignment Care Compare group NPD
• Upstate Community Medical, PC

  • Hospitalist Physician
  • Syracuse, NY
  • NPI 1689620163
  Medicare reassignment Care Compare group
• Emergency Care Services of New York, P.C.

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1639236656
  Medicare reassignment
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment
• Cny North Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1962901389
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1649481409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141985",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141985",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBBY",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02925964",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "J400002999",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadine Khouzam, MD
• Bann Rami Khalil Khraisat, MD
• Kamal Khurana, MD
• Kristina Khurshudian, OTR
• Dara Renee Kibby X, REGISTERED NURSE
• Nancy Marie Kibby, FNP
• Jalia N Kibirige I
• Martha Mary Kicak, LPN
• Patti-Ann Kick, MSN, ANP-C
• Faiz Kidwai, DO, MPH

• Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.