Kathleen Ann Kelley, MD, R.PH

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

164393-1 Issued in NY

Practice address

2943 Seneca Street
West Seneca, NY 14224-1950

Phone

(716) 825-3601

Fax

(716) 825-2850

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Registered Pharmacist

State licenses

Practice roles

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.

• Wny Breast Med and Surg Care,PC

  • Specialist
  • Orchard Park, NY
  • NPI 1215115662
  NPD (past) Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1871501353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SOUTHWICK DRIVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271650",
            "telephone_number": "716-662-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2943 SENECA STREET",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241950",
            "telephone_number": "716-825-3601",
            "fax_number": "716-825-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "MD, R.PH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0003513",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "164393-1",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21979",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "1706438",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDELES CARE",
            "identifier": "040426000362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENIOR DEVICE UNIVERA",
            "identifier": "00010089001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000527022003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01209521",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMANS COMP",
            "identifier": "0151643931",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Claire Keating, LCSW
• Brittanny Jo Keeler, D.O.
• Daniel Robert Keller, DPT
• Briana Rose Kelley, PA
• Karen Lee Kelley
• Ryan Patrick Kelley
• Marie Kellner, RPH
• Kelly a. Hauser, RN
• Joshua Matthew Kelly, PHARMD
• Kara Danielle Kelly, M.A., CCC-SLP

• Surgery Physician in West Seneca, NY
• Providers in West Seneca, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.