Individual provider Active NPI

Lisa Marie Kalinka, NP

  • Nurse Practitioner
  • Amherst, NY
National Provider Identifier
1821136342
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
304574 Issued in NY
Practice address
4979 Harlem Rd
Amherst, NY 14226-2547
Phone
(716) 923-4380
Fax
(716) 923-4384
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 304574 NY Primary

Addresses

Primary practice location

4979 Harlem Rd
Amherst, NY 14226-2547

Mailing address

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

Other identifiers 5

IdentifierTypeStateIssuer
9514160OtherNYINDEPENDENT HEALTH
080725000013OtherNYFIDELISCARE
000529056003OtherNYBC/BS
02862568MedicaidNY
000529056002OtherNYBC/BS WNY

Other names 1

  • Lisa Marie Pennisten Other name

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
I20071219000096 NY Practitioner - Nurse Practitioner 8921198623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2014 Accepting new patients
Erie County Medical Center Corporation CurrentSince Sep 1, 2014 Accepting new patients
Geriatric Associates, LLP PastSince Jul 25, 2019 Accepting new patients
Buffalo Neurosurgery PC Past Accepting new patients

Locations

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1821136342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4380",
            "fax_number": "716-923-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4380",
            "fax_number": "716-923-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALINKA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9514160",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELISCARE",
            "identifier": "080725000013",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000529056003",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02862568",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS WNY",
            "identifier": "000529056002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "PENNISTEN",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.