Individual provider Active NPI

Ryan Patrick Kelley

  • Speech-Language Pathologist
  • West Seneca, NY
National Provider Identifier
1982835732
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019244 Issued in NY
Practice address
1200 E and West Rd
West Seneca, NY 14224-3604
Phone
(716) 885-8318
Fax
(716) 681-9875
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 019244 NY Primary

Addresses

Primary practice location

1200 E and West Rd
West Seneca, NY 14224-3604

Mailing address

1200 E and West Rd
Buffalo, NY 14224-3604
Phone (716) 885-8318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091015000083 NY Practitioner - Qualified Speech Language Pathologist 5698811024 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Ddso Clinic Pittsford CurrentSince May 3, 2023 Accepting new patients
Chautauqua County Chapter of Nysarc Inc Past Accepting new patients
Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center PastSince Aug 6, 2006 Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

106 Pine St
Hamburg, NY 14075
Phone (716) 646-0048

1200 East and West Rd
Bldg 16
West Seneca, NY 14224
Phone (716) 517-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1982835732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E AND WEST RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142243604",
            "telephone_number": "716-885-8318",
            "fax_number": "716-681-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E AND WEST RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243604",
            "telephone_number": "716-885-8318",
            "fax_number": "716-681-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.