NPIMap

Individual provider Active NPI

Michelle Katherine Addison

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1043820251
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346255 Issued in NY
Practice address
20 Hagen Dr Ste 330
Rochester, NY 14625-2664
Phone
(585) 267-4040
NPI assigned
Aug 3, 2020
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 346255 NY Primary

Addresses

Primary practice location

20 Hagen Dr Ste 330
Rochester, NY 14625-2664

Mailing address

109 Armstrong Ave
Rochester, NY 14617-4603
Phone (716) 957-8537

Other names 1

  • Michelle Katherine Hiczun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201002001031 NY Practitioner - Nurse Practitioner 3678992187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Care of Long Island PLLCGroup PAC ID 7517042211, 175 clinicians
Rochester Gastroenterology AssociatesGroup PAC ID 3678552973, 10 clinicians

Practice addresses (Care Compare)

103 Canal Landing Blvd
Suite 12
Rochester, NY 14626-5108
Phone (585) 227-1080

20 Hagen Dr
Suite 330
Rochester, NY 14625-2664
Phone (585) 267-4040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
346255NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Care of Long Island PLLC CurrentSince Jun 1, 2025 Accepting new patients
Rochester Gastroenterology Associates CurrentSince Oct 1, 2020 Accepting new patients
Nyc Medical of Queens PC PastSince Mar 9, 2020 Accepting new patients
Gastroenterology Group of Rochester, LLP Past Accepting new patients

Locations

1375 Washington Ave
Ste 101
Albany, NY 12206
Phone (518) 438-4483

101 Lincoln Pkwy
East Rochester, NY 14445

101 Lincoln Pkwy
Ste 4
East Rochester, NY 14445

7916 37th Ave
Jackson Heights, NY 11372
Phone (212) 927-0013

187 Veterans Blvd
Massapequa, NY 11758
Phone (516) 795-5523

103 Canal Landing Blvd
Ste 12
Rochester, NY 14626
Phone (585) 227-1080

115 Canal Landing Blvd
Ste 110
Rochester, NY 14626
Phone (585) 227-1080

20 Hagen Dr
Ste 330
Rochester, NY 14625
Phone (585) 267-4040

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAEACD
  • Direct secure messaging: mhiczun306605@direct.rochesterregional.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1043820251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ARMSTRONG AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174603",
            "telephone_number": "716-957-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HAGEN DR STE 330",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252664",
            "telephone_number": "585-267-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "MICHELLE",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "HICZUN",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.