Sophia Kruly, RD,CDN,CDE is a medicare enrolled "Nutritionist" in Buffalo, New York. Her current practice location is
135 Grant St, Buffalo, New York. You can reach out to her office (for appointments etc.) via phone at
(716) 881-4300.
Sophia Kruly is licensed to practice in New York (license number 003464-1) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689630824.
Provider's Profile
| Full Name | Sophia Kruly |
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| Gender | Female |
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| Speciality | Nutritionist |
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| Location | 135 Grant St, Buffalo, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689630824
- Provider Enumeration Date: 04/25/2006
- Last Update Date: 10/06/2020
Medicare PECOS Information:
- PECOS PAC ID: 0547288912
- Enrollment ID: I20051103000863
Medical Identifiers
Medical identifiers for Sophia Kruly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689630824 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163WN1003X | Registered Nurse - Nutrition Support | 003464 (New York) | Secondary |
| 133N00000X | Nutritionist | 003464-1 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sophia Kruly allows following entities to bill medicare on her behalf.
| Entity Name | Kaleida Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366473183
PECOS PAC ID: 7810805280
Enrollment ID: O20031105000212 |
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| Entity Name | Wny Medical Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154421246
PECOS PAC ID: 9335191733
Enrollment ID: O20050214000821 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sophia Kruly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sophia Kruly, RD,CDN,CDE
908 Niagara Falls Blvd, Suite 208,
North Tonawanda, NY 14120-2019
Ph: (716) 692-3302 | Sophia Kruly, RD,CDN,CDE
135 Grant St,
Buffalo, NY 14213-1604
Ph: (716) 881-4300 |
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