NPIMap

Individual provider Active NPI

Kelly A Halcomb, RPA C

  • Physician Assistant
  • Hamburg, NY
National Provider Identifier
1811933856
Registry record updated Jul 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010492 Issued in NY
Practice address
4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone
(716) 646-1084
Fax
(716) 646-0763
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2014

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 010492 NY Primary

Addresses

Primary practice location

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600

Mailing address

4855 Camp Rd
Suite 100
Hamburg, NY 14075-2600
Phone (716) 646-1084

Other identifiers 1

IdentifierTypeStateIssuer
02651090MedicaidNY

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
I20050325000569 NY Practitioner - Physician Assistant 3072569615 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5290 Military Rd
Suite 8
Lewiston, NY 14092-1953
Phone (716) 298-3000

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 297-4800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Wny PC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Kenmore Mercy Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Apr 6, 2015 Accepting new patients
Trinity Medical Wny PC Physician Assistant CurrentSince Jul 1, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary's Hospital of Niagara Falls Physician Assistant Past Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

4855 Camp Rd
Ste 100
Hamburg, NY 14075
Phone (716) 646-1084

5290 Military Rd
Ste 8
Lewiston, NY 14092
Phone (716) 297-9379

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Interoperability endpoints

  • Direct secure messaging: khalcomb20376@direct.chsbuffalo.org

Organizations & group practices 10

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 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405814400000",
    "number": "1811933856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752600",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 CAMP RD",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140752600",
            "telephone_number": "716-646-1084",
            "fax_number": "716-646-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALCOMB",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RPA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2014-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02651090",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.