OrganizationActive
Ellicottville Medical
NPI 1902566748 · Pediatrics Physician · Ellicottville, NY
Ellicottville Medical is a Pediatrics Physician organization in Ellicottville, NY (NPI 1902566748).
Provider details
- NPI number
- 1902566748
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Katelyn Johnson-Clark, Owner(941) 441-7804
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5 Park Sq
Ellicottville, NY 14731-7014
Phone: (716) 257-4397
Street-level locationGet directions
Mailing address
Po Box 1252
Ellicottville, NY 14731-1252
Registry dates
- Enumerated
- 2021-12-21
- Last updated
- 2021-12-21
- Certified
- 2021-12-21
Frequently asked questions
- What is Ellicottville Medical's NPI number?
- Ellicottville Medical's National Provider Identifier (NPI) is 1902566748, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ellicottville Medical?
- Ellicottville Medical is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Ellicottville Medical located?
- Ellicottville Medical's practice location on file with NPPES is 5 Park Sq, Ellicottville, NY 14731-7014.
- What is Ellicottville Medical's phone number?
- The practice phone number listed in the NPPES registry for Ellicottville Medical is (716) 257-4397.
- Who is the authorized official for Ellicottville Medical?
- The authorized official listed on Ellicottville Medical's NPPES record is Katelyn Johnson-Clark, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ellicottville Medical's NPI active?
- Yes — Ellicottville Medical's NPI (1902566748) is active in the NPPES registry as of the last update on 2021-12-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.