Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Lynn Manganello, PA

Individual provider Physician Assistant · NPI 1669638953

Kelly Lynn Manganello, PA is a Physician Assistant in Williamsville, New York. Qualified in 2008, 18 years ago. Practices with Western New York Dermatology PLLC, a 15-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

297 Spindrift Dr
Williamsville, NY 14221-7894
Phone: (716) 831-2600
Fax: (716) 831-2601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 012668 (NY)

Record details

NPI number1669638953
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 6, 2008
Last updated in NPPESMay 11, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Western New York Dermatology Pllc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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