Individual provider Active NPI

Mary Ellen Kranock

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1770672065
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049293-1 Issued in NY
Practice address
5500 Main St
Suite 207
Williamsville, NY 14221-6755
Phone
(716) 505-5634
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R049293-1 NY Primary

Addresses

Primary practice location

5500 Main St
Suite 207
Williamsville, NY 14221-6755

Mailing address

215 Martin Rd
Akron, NY 14001-9101
Phone (585) 542-6428

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040731000166 NY Practitioner - Clinical Social Worker 9032189402 Practice locations: Williamsville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5500 Main St
Suite 207
Williamsville, NY 14221-6737
Phone (716) 633-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R049293-1NYMDClinical Social Worker
049293NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770672065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MARTIN RD",
            "city": "AKRON",
            "state": "NY",
            "postal_code": "140019101",
            "telephone_number": "585-542-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST",
            "address_2": "SUITE 207",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216755",
            "telephone_number": "716-505-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANOCK",
        "first_name": "MARY ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049293-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.