NPIMap

Individual provider Active NPI

Paul Campana

  • Family Medicine Physician
  • Kenmore, NY
National Provider Identifier
1740627942
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
283025 Issued in NY
Practice address
2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone
(716) 875-6700
Fax
(716) 875-6853
NPI assigned
May 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 283025 NY Primary

Addresses

Primary practice location

2914 Elmwood Ave
Kenmore, NY 14217-1332

Mailing address

2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone (716) 875-6700

Other identifiers 2

IdentifierTypeStateIssuer
04492375MedicaidNY
539173001OtherNYBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160729000122 NY Practitioner - Family Practice 5092005371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Kenmore Family Medicine LLPGroup PAC ID 6901895036, 5 clinicians

Practice addresses (Care Compare)

2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone (716) 875-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kenmore Family Medicine, LLP Family Medicine CurrentSince Jul 18, 2016 Accepting new patients

Locations

2914 Elmwood Ave
Kenmore, NY 14217
Phone (716) 447-6310

Interoperability endpoints

  • Direct secure messaging: pcampana@kenmorefamilymedicine.medentdirect.com

Organizations & group practices 1

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 10

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": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1740627942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-875-6700",
            "fax_number": "716-875-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-875-6700",
            "fax_number": "716-875-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANA",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-29",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "283025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04492375",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "539173001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

Verify at the official NPI Registry.