KELLY WILLIAMS
NPI 1043720956
Physician Assistant - Medical in Syracuse, NY

Q: What is Kelly Williams's NPI number?

The NPI number for Kelly Williams is 1043720956. It was assigned to this individual provider in the NPPES registry on October 5, 2017.

Q: What is Kelly Williams's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Williams was last updated on January 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 05, 2017PECOS EnrolledAccepts Medicare Assignment

329 N SALINA ST, SYRACUSE, NY 13203(315) 471-1564 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Kelly Williams NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY WILLIAMS (NPI 1043720956) is an individual medical provider in Syracuse, New York, licensed in New York (021455) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1043720956

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKELLY WILLIAMS

Location Address329 N SALINA STSyracuse, NY 13203-1755

Mailing Address108 Terrace CirSyracuse, NY 13214-1232

Phone(315) 471-1564

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 5, 2017

Last NPPES UpdateJanuary 9, 2025

NPPES CertifiedJanuary 9, 2025

✔ NPI 1043720956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NY · 021455

329 N SALINA ST, Syracuse, NY 13203

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Williams is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537412234

PECOS Enrollment IDI20181026000413

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAYE HABEL

Marriage & Family Therapist