Individual provider Active NPI

Melissa J O'Sullivan, N P

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1083752034
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300749 Issued in NY
Practice address
1870 Winton Rd S
BLDG 4 Suite 1
Rochester, NY 14618-3916
Phone
(585) 473-0495
Fax
(585) 442-0750
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300749 NY Primary

Addresses

Primary practice location

1870 Winton Rd S
BLDG 4 Suite 1
Rochester, NY 14618-3916

Mailing address

1870 Winton Rd S
BLDG 4 Suite 1
Rochester, NY 14618-3916
Phone (585) 473-0495

Other practice location 1

30 Hagen Dr Ste 100
Rochester, NY 14625-2658
Phone (585) 442-5320

Other practice location 2

1415 Portland Ave Ste 445
Rochester, NY 14621-3022
Phone (585) 442-5320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119000139 NY Practitioner - Nurse Practitioner 1456656669 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F300749NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Springs Sanitarium Co CurrentSince Nov 2, 2020 Accepting new patients
Rochester General Hospital Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Nov 2, 2020 Accepting new patients
Rochester General Hospital CurrentSince Nov 2, 2020 Accepting new patients
Rochester General Hospital CurrentSince Nov 2, 2020 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1415 Portland Ave
Ste 445
Rochester, NY 14621
Phone (585) 922-3576

30 Hagen Dr
Ste 100
Rochester, NY 14625
Phone (585) 242-9450

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1083752034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 WINTON RD S",
            "address_2": "BLDG 4 SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183916",
            "telephone_number": "585-473-0495",
            "fax_number": "585-442-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 WINTON RD S",
            "address_2": "BLDG 4 SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183916",
            "telephone_number": "585-473-0495",
            "fax_number": "585-442-0750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Hagen Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252658",
            "country_code": "US",
            "telephone_number": "585-442-5320",
            "fax_number": "585-442-5526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 Portland Ave Ste 445",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213022",
            "country_code": "US",
            "telephone_number": "585-442-5320",
            "fax_number": "585-442-5526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "N P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.