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

Mrs. Mallory Lynn Kelly, RPA-C

Individual provider Physician Assistant · NPI 1730414111

Mrs. Mallory Lynn Kelly, RPA-C is a Physician Assistant in West Seneca, New York. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2009
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Practice location Address checks out

290 Center Rd
West Seneca, NY 14224-1945
Phone: (716) 675-7693
Fax: (855) 714-1253
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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 013603 (NY)

Record details

NPI number1730414111
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA-C
Sole proprietorYes
NPI enumeratedOctober 2, 2009
Last updated in NPPESOctober 8, 2021
Certification dateOctober 7, 2021

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)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in West Seneca