Active NPI
Kevin G Cleary, MD
- Internal Medicine Physician
- Depew, NY
National Provider Identifier
1831156447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 200751
- Practice address
- 4893 Transit Rd
Depew, NY 14043-4776 - Phone
- (716) 608-7040
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 200751 | NY | Primary |
Addresses
Primary practice location
4893 Transit Rd
Depew, NY 14043-4776
Mailing address
4893 Transit Rd
Depew, NY 14043-4776
Phone (716) 608-7040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01657083 | Medicaid | NY |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100630000000 | NY | Practitioner - Internal Medicine | 5294648473 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Louisiana State University School of Medicine in New Orleans, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- General Physician PC
Practice addresses (Care Compare)
4893 Transit Rd
Depew, NY 14043-4698
Phone (716) 608-7040
Hospital & facility affiliations
- Vna of Western Ny Chha
- McAuley Seton Home Care Corp Chha
- Amedisys Home Health Care (Amherst)
- Kaleida Health
- Sisters of Charity Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Physician, PC | Current | Accepting new patients | |
| Southgate Medical Group,LLP | Internal Medicine | Past | Accepting new patients |
Locations
4893 Transit Rd
Depew, NY 14043
Phone (716) 608-7040
3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515
Interoperability endpoints
- kcleary@gppc.medentdirect.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- West Seneca, NY
- NPI 1487611927
Internal Medicine
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Cheektowaga, NY
- NPI 1699772343
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
Hospital
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1790727543
Hospital
-
- Home Health Agency
- Williamsville, NY
- NPI 1730134529
-
- Home Health Agency
- Cheektowaga, NY
- NPI 1730268384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330387200000",
"number": "1831156447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4893 TRANSIT RD",
"city": "DEPEW",
"state": "NY",
"postal_code": "140434776",
"telephone_number": "716-608-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4893 TRANSIT RD",
"city": "DEPEW",
"state": "NY",
"postal_code": "140434776",
"telephone_number": "716-608-7040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARY",
"first_name": "KEVIN",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2012-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "200751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01657083",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Depew, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.