Individual provider Active NPI

Kelsey Jean Carminati, P.A

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1710338017
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019762-1 Issued in NY
Practice address
61 Maple Rd
Buffalo, NY 14221-2918
Phone
(716) 565-1234
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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 019762-1 NY Primary

Addresses

Primary practice location

61 Maple Rd
Buffalo, NY 14221-2918

Mailing address

61 Maple Rd
Buffalo, NY 14221-2918
Phone (716) 565-1234

Other practice location 1

100 High St. Section B2
Buffalo, NY 14203-1420
Phone (716) 710-8266

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
I20160922001318 NY Practitioner - Physician Assistant 2163719998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 884-3000

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019762NYMDSpeech-Language Pathologist
019762-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC CurrentSince Feb 9, 2020 Accepting new patients
Trinity Medical Wny PC Physician Assistant CurrentSince Feb 9, 2020 Accepting new patients
Northtowns Imaging PC Past Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

Interoperability endpoints

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

Organizations & group practices 5

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 6

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1710338017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234",
            "fax_number": "716-565-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAPLE RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142212918",
            "telephone_number": "716-565-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 High St. Section B2",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031420",
            "country_code": "US",
            "telephone_number": "716-710-8266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMINATI",
        "first_name": "KELSEY",
        "middle_name": "JEAN",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019762-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.