Kimberly Roaldi, PA
Individual provider Active NPI Internal Medicine Physician · Bowmansville, NY
NPI 1841940970 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1841940970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 028165 (NY)
- Practice address
- 5196 Genesee St
Bowmansville, NY 14026-1038 - Phone
- (716) 681-1895
- Fax
- (716) 681-5439
- NPI assigned
- Mar 23, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Maple Internal Medicine and Pediatrics PLLC
Mobile Physician Services PLLC
Practice addresses (Care Compare)
1835 Maple Rd
Suite 1
Williamsville, NY 14221-2780
Phone (716) 634-1168
4650 Southwestern Blvd
Hamburg, NY 14075-1939
Phone (716) 648-2450
Hospital & facility affiliations
- Willcare Chha (Buffalo)
- Amedisys Home Health Care (Amherst)
- Sisters of Charity Hospital
- Kaleida Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231128002958 | NY | Practitioner - Physician Assistant | 9436507696 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028165 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple Internal Medicine & Pediatrics, PLLC | Internal Medicine | Current |
Accepting new patients |
Locations
1835 Maple Rd
Ste 1
Williamsville, NY 14221
Phone (716) 634-1168
Interoperability endpoints
- kroaldi@mobileprimarycare.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 028165 | NY | Yes |
Addresses
Primary practice location
5196 Genesee St
Bowmansville, NY 14026-1038
Mailing address
5196 Genesee St
Bowmansville, NY 14026-1038
Phone (716) 681-1895
Other providers in Bowmansville, NY
- Oxymed Corporation
- Anne Marie Pegg
- Philip a Penepent Jr.
- Michael Rabice
- Allyson Roach
- Meghan Root
- John Schwab
- Teresa Siejak
- Brittney Lee Soodsma
- Julie Ann St. John
All providers in Bowmansville, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.