Kellie E Heftka, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011382 Issued in NY

Practice address

120 Gardenville Pkwy W
West Seneca, NY 14224-1324

Phone

(716) 668-3600

Fax

(716) 656-4274

NPI assigned

Sep 26, 2006

Last updated

Jul 9, 2009By the provider in NPPES

Sex

Female

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 5

Other names 1

• Kellie E Krawczyk Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kellie.heftka.1@29290.direct.athenahealth.com

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.

• Buffalo Spine Medicine & Rehab PLLC

  dba Buffalo Spine & Sports Medicine

  • Physical Medicine & Rehabilitation Physician
  • Williamsville, NY
  • NPI 1326394701
  Medicare reassignment
• Midtown East Medical Services, PC

  • Nurse Practitioner
  • Pittsford, NY
  • NPI 1801292800
  Medicare reassignment

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1740381946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GARDENVILLE PKWY W",
            "address_2": "ATTN: BETTY PICCILLO",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241324",
            "telephone_number": "716-857-6150",
            "fax_number": "716-656-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GARDENVILLE PKWY W",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241324",
            "telephone_number": "716-668-3600",
            "fax_number": "716-656-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFTKA",
        "first_name": "KELLIE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW BCBS #",
            "identifier": "000528804001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE # SD",
            "identifier": "070111000099",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA #",
            "identifier": "9514067",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE # AU",
            "identifier": "070111000100",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE #",
            "identifier": "190433DL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "KRAWCZYK",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret M Hayek, RN
• Tara Haynes-Herbert, PA-C
• Delores Ann Hazelton
• Karen Marie Healy
• Heather Zukowski, LCSW, PLLC
• Catherine M Heimback-Murdie, LCSW-R
• Mariah L Heller, LBA, BCBA
• Helping Today ABA
• Gray Hendershot, PT
• Denise C Hendricks, RPH

• 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 Jul 9, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.