Mallory Lynn Kelly, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013603 Issued in NY

Practice address

290 Center Rd
West Seneca, NY 14224-1945

Phone

(716) 675-7693

Fax

(855) 714-1253

NPI assigned

Oct 2, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Martin A Casey, M.D.

  • Family Medicine Physician
  • West Seneca, NY
  • NPI 1205890308
  Medicare reassignment
• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  Medicare reassignment
• Frederick M. Occhino, D.O.,P.C.

  • Family Medicine Physician
  • Hamburg, NY
  • NPI 1306927157
  NPD (past)

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

• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543
  Care Compare affiliation

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1730414111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241945",
            "telephone_number": "716-675-7693",
            "fax_number": "855-714-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241945",
            "telephone_number": "716-675-7693",
            "fax_number": "855-714-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MALLORY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Patrick Kelley
• Marie Kellner, RPH
• Kelly a. Hauser, RN
• Joshua Matthew Kelly, PHARMD
• Kara Danielle Kelly, M.A., CCC-SLP
• Mary Alice Kelly, MD
• Michael H Kelly, L.M.T.
• Thomas Paul Kenjarski, DDS
• Alison Kern
• Pamela Sue Kessler

• Physician Assistant in West Seneca, NY
• Providers in West Seneca, 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 Oct 8, 2021; 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.