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KAELEY GRIDLEY LMSW
NPI 1821750415
Social Worker in Syracuse, NY

Active since October 11, 2021PECOS Enrolled
1045 JAMES ST STE 100, SYRACUSE, NY 13203(315) 425-1004 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 10, 2025, Oct 11, 2021 (2 updates tracked since 2021).

About Kaeley Gridley Lmsw NPPES

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

KAELEY GRIDLEY LMSW (NPI 1821750415) is an individual social worker in Syracuse, New York, licensed in New York (111192) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821750415
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKAELEY GRIDLEYCredential: LMSW
Location Address1045 JAMES ST STE 100Syracuse, NY 13203-2758
Mailing Address1045 James St Ste 100Syracuse, NY 13203-2758
Phone(315) 425-1004
Sole ProprietorNo
Enumeration DateOctober 11, 2021
Last NPPES UpdateSeptember 10, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1821750415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NY · 111192
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaeley Gridley Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kaeley Gridley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Liberty Resources Inc.
Mental Health (Including Community Mental Health Center)
1045 JAMES ST
Syracuse, NY 13203
  • Reassigned Medicare billing, New York enrollment
  • 156 clinicians in this Medicare group
NPI 1225254881 (315) 425-1004

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MS. HEIDI M ZIERVOGEL LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MR. MARCIN ROBERT ZAK LMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
CAITLIN BECKER
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
ADRIANA SOTOLONGO LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 425-1004
KAYLA CUNNINGHAM LMHC
Counselor
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MARTA MULHOLLAND PLMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
JULIA DOROTHY KOSOWSKY
Nurse Practitioner (Primary Care)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 425-1004
MAGGIE PRUSINOWSKI
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 424-1004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaeley Gridley's NPI number?

The NPI number for Kaeley Gridley is 1821750415. It was assigned to this individual provider in the NPPES registry on October 11, 2021.

Where is Kaeley Gridley located?

Kaeley Gridley practices at 1045 James St Ste 100, Syracuse, NY 13203. The listed phone number is (315) 425-1004.

What is Kaeley Gridley's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Kaeley Gridley enrolled in Medicare?

Yes. Kaeley Gridley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaeley Gridley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaeley Gridley reassigns Medicare benefits to Liberty Resources Inc. (Syracuse, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kaeley Gridley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kaeley Gridley was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.