Individual provider Active NPI

Kacy L Zelesnikar, PA

  • Physician Assistant
  • Endicott, NY
National Provider Identifier
1750682894
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014462 Issued in NY
Practice address
415 E Main St
Endicott, NY 13760-4925
Phone
(607) 785-2460
Fax
(607) 785-2584
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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 014462 NY Primary

Addresses

Primary practice location

415 E Main St
Endicott, NY 13760-4925

Mailing address

415 E Main St
Endicott, NY 13760-4925
Phone (607) 785-2460

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
I20110207000502 NY Practitioner - Physician Assistant 8921288010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Physician Assistant Current Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Apr 1, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Apr 1, 2011 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

415 E Main St
Endicott, NY 13760
Phone (607) 785-2460

501 Reynolds Rd
Johnson City, NY 13790
Phone (607) 797-6071

3101 Shippers Rd
Ste 102
Vestal, NY 13850
Phone (607) 251-2100

Interoperability endpoints

  • Direct secure messaging: kzelesnikar196624@direct-guthrie.org

Organizations & group practices 4

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 1

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": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1750682894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604925",
            "telephone_number": "607-785-2460",
            "fax_number": "607-785-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604925",
            "telephone_number": "607-785-2460",
            "fax_number": "607-785-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELESNIKAR",
        "first_name": "KACY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

Verify at the official NPI Registry.