Individual provider Active NPI

Shiane Laken Irwin, FNP

  • Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1154115574
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
355658 Issued in NY
Practice address
400 Red Creek Dr Ste 110
Rochester, NY 14623-4273
Phone
(585) 486-0147
NPI assigned
Apr 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 355658 NY Primary

Addresses

Primary practice location

400 Red Creek Dr Ste 110
Rochester, NY 14623-4273

Mailing address

601 Elmwood Ave Box Med
Rochester, NY 14642-0001

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
I20250916002788 NY Practitioner - Nurse Practitioner 0648774489 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary M Parkes Asthma and PulmonaryGroup PAC ID 9436126596, 36 clinicians

Practice addresses (Care Compare)

400 Red Creek Dr
Suite 110
Rochester, NY 14623-4273
Phone (585) 486-0147

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
355658NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Sep 8, 2025 Accepting new patients
Pulmonary Disease Clinical Group CurrentSince Sep 8, 2025 Accepting new patients
Mary M Parkes Asthma & Pulmonary CurrentSince Sep 8, 2025 Accepting new patients
University of Rochester Current Accepting new patients
University of Rochester CurrentSince Sep 8, 2025 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients

Locations

400 Red Creek Dr
Ste 110
Rochester, NY 14623
Phone (585) 486-0147

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

400 Red Creek Dr
Rochester, NY 14623
Phone (585) 334-5560

Interoperability endpoints

  • Direct secure messaging: sirwin210583@direct.urmc.rochester.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1154115574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RED CREEK DR STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234273",
            "telephone_number": "585-486-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "SHIANE",
        "middle_name": "LAKEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "355658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.