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Contact Information

Kaleida Health
Medical Staff Office

1028 Main Street
Buffalo, NY 14203

  • (716) 859-5501
cardiac

Doctor at bedsideMedical/Dental Staff
Application

Thank you for your interest in Kaleida Health.

In order to receive privileges at Kaleida Health, applicants are required to complete the Medical/Dental Staff Application form and an online learning tutorial.

Please refer to the FAQ section if you have questions on the application process. If you need assistance please call the Medical Staff Office at (716) 859-5501.

Step 1

Application LinkComplete the
Physician Application

A check sheet within the document will assist you in completing the form and submitting all required information.
Download PDF

OR

Step 1

Application Link Advanced Practice Provider Application
A check sheet within the document will assist you in completing the form and submitting all required information.
Download PDF

Note:

Application LinkKaleida Health Bundled Payment Shared Savings Program
The Kaleida Health Bundled Payment Shared Savings Program is intended to incentivize practitioners to participate in specified quality metrics, in order to improve the quality, patient experience and cost-effectiveness of care provided to applicable Medicare beneficiaries.
Download Form A        Download Form B

Step 2

Submit the Application and Required Forms
Send to: Kaleida Health Medical Staff Office
1028 Main Street, 3rd Floor
Buffalo, NY 14202

Step 3

Appointment Fee Payment
As a convenience, you may pay your non-refundable appointment fee using any major credit card. Otherwise, please include a check as per the application instructions.
Make Payment