Individual provider Active NPI

Nicole J Walsh, PNP

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1124697305
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383255 Issued in NY
Practice address
200 E River Rd
Rochester, NY 14623-1212
Phone
(585) 275-2808
Fax
(585) 275-3683
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 383255 NY
Pediatric Nurse Practitioner 363LP0200X F383255 NY Primary

Addresses

Primary practice location

200 E River Rd
Rochester, NY 14623-1212

Mailing address

601 Elmwood Ave Box 278984
Rochester, NY 14642-0001
Phone (585) 275-2808

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nwalsh73373@direct.urmc.rochester.edu Direct
Direct Messaging Address nwalsh73373@direct.urmc.rochester.edu 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
I20210809001868 NY Practitioner - Nurse Practitioner 1355745621 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
383255NYMDOrthopaedic Hand Surgery Physician
F383255NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 1, 2021 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 1, 2021 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
U of R Neurology Department CurrentSince Aug 1, 2021 Accepting new patients

Locations

601 Elmwood Ave
#278984
Rochester, NY 14642
Phone (585) 275-1200

601 Elmwood Ave
#631
Rochester, NY 14642
Phone (585) 275-2808

200 E River Rd
Rochester, NY 14623
Phone (585) 275-2808

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 6

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1124697305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 278984",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2808",
            "fax_number": "585-275-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E RIVER RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231212",
            "telephone_number": "585-275-2808",
            "fax_number": "585-275-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2023-07-07",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NY",
            "license": "383255",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwalsh73373@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwalsh73373@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.