Andrea Klimtzak, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010679 Issued in NY

Practice address

112 Olean St
Suite 220
East Aurora, NY 14052-2540

Phone

(716) 805-1072

Fax

(716) 805-1073

NPI assigned

Mar 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Aurora Family Practice,LLPGroup PAC ID 5496733404, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• East Aurora Family Practice,LLP

  • Family Medicine Physician
  • East Aurora, NY
  • NPI 1801853320
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921
  Care Compare affiliation

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1902874688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMTZAK",
        "first_name": "ANDREA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00027264901",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02699627",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "172119BF",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512871",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000570550001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "051031000028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Kamp, AU.D
• Amber Keicher
• Brianna Leigh Keppner, PHARMD
• Kishel Physical Therapy PLLC
• Sean Matthew Kishel, PT, DPT
• Amanda Kline, LMT
• Kelly Yvonne Kloc
• Emily Victoria Knitter, PHD
• David Michael Koeppel
• Sheri A Kompinski

• Physician Assistant in East Aurora, NY
• Providers in East Aurora, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.

Verify at the official NPI Registry.