Individual provider Active NPI

Madelene Kirsten Mancuso, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1164194221
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403773 Issued in NY
Practice address
1000 Elmwood Ave
Rochester, NY 14620-3042
Phone
(585) 271-2520
Fax
(585) 286-9220
NPI assigned
Sep 28, 2021
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403773 NY Primary

Addresses

Primary practice location

1000 Elmwood Ave
Rochester, NY 14620-3042

Mailing address

1000 Elmwood Ave
Rochester, NY 14620-3042
Phone (585) 271-2520

Other names 1

  • Madelene Kirsten Weick Former name

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
I20231116002442 NY Practitioner - Nurse Practitioner 0941657654 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester Rehabilitation Center, Inc.Group PAC ID 4880683218, 3 clinicians

Practice addresses (Care Compare)

1000 Elmwood Ave
Rochester, NY 14620-3097

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
403773NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Finger Lakes United Cerebral Palsy, Inc. CurrentSince Oct 11, 2023 Accepting new patients
Rochester Rehabilitation Center, Inc CurrentSince Oct 11, 2023 Accepting new patients
United Cerebral Palsy Association of the Rochester Area, Inc. CurrentSince Oct 11, 2023 Accepting new patients
Rochester Rehabilitation Center Past Accepting new patients

Locations

5415 N Bloomfield Rd
Canandaigua, NY 14424
Phone (585) 394-1190

731 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-6828

1000 Elmwood Ave
Ste 600
Rochester, NY 14620
Phone (585) 471-0559

1100 Elmwood Ave
Rochester, NY 14620
Phone (585) 271-0680

3399 Winton Rd S
Rochester, NY 14623

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7c4ed6b7-c140-41eb-bc5a-5ee81640f80d/

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 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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1164194221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203042",
            "telephone_number": "585-271-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203042",
            "telephone_number": "585-271-2520",
            "fax_number": "585-286-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "MADELENE",
        "middle_name": "KIRSTEN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELENE",
            "last_name": "WEICK",
            "middle_name": "KIRSTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.