Individual provider Active NPI

Kristen Carnahan, NP

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1104221506
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382485-1 Issued in NY
Practice address
222 Alexander St
4TH Floor
Rochester, NY 14607-4039
Phone
(585) 922-8230
NPI assigned
Oct 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F382485-1 NY Primary

Addresses

Primary practice location

222 Alexander St
4TH Floor
Rochester, NY 14607-4039

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-8230

Other names 1

  • Kristen Glover Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kglover160177@direct.rochesterregional.org Direct

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
I20150105001420 NY Practitioner - Nurse Practitioner 0042533739 Reassigns benefits to 2 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
F382485-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince May 1, 2020 Accepting new patients
Western New York Medical Practice P.C CurrentSince May 1, 2020 Accepting new patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital CurrentSince Dec 1, 2014 Accepting new patients
Rochester General Hospital CurrentSince Dec 1, 2014 Accepting new patients

Locations

222 Alexander St
Rochester, NY 14607
Phone (585) 546-3280

222 Alexander St
Fl 4
Rochester, NY 14607
Phone (585) 922-8070

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

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

222 Alexander St
Ste 4100
Rochester, NY 14607
Phone (585) 922-8225

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": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1104221506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-8230",
            "fax_number": "585-922-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ALEXANDER ST",
            "address_2": "4TH FLOOR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074039",
            "telephone_number": "585-922-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNAHAN",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382485-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kglover160177@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "222 Alexander St",
            "address_2": "4th Floor",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146074039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GLOVER",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.