KSP Health - Ny LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KSP HEALTH - NY LLC

Practice address

418 Broadway Ste R
Albany, NY 12207-2922

Phone

(234) 260-6212

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Muthukumar Vellaichamy, MD

Title

Owner

Phone

(234) 260-6212

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1740050608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6446 E CENTRAL AVE STE 183",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061923",
            "telephone_number": "234-260-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE R",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "234-260-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSP HEALTH - NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "VELLAICHAMY",
        "authorized_official_first_name": "MUTHUKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "234-260-6212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey M Kruse, MPT
• Kelly Lynn Kryczkowski, OT
• Thomas John Kryzak Jr., M.D.
• Emma Kryzanski, MD
• Patryk Krzesaj, MD
• Marc Kucharik, M.S. ED. CCC-SLP
• Michelle K Kuchis, FNP
• Karin Kuck, BA
• Tracy Kuebler
• David H Kuehler, M.D.

• Pediatrics Physician in Albany, NY
• Providers in Albany, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.