Individual provider Active NPI

Kayleigh Mertz, LCSW

  • Social Worker
  • Rochester, NY
National Provider Identifier
1164786729
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
083749 Issued in NY
Practice address
2060 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2792
Phone
(585) 271-0661
Fax
(585) 244-2871
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 083749 NY Primary

Addresses

Primary practice location

2060 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2792

Mailing address

2060 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2792
Phone (585) 271-0661

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401000516 NY Practitioner - Clinical Social Worker 9436566858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083749NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc CurrentSince Nov 24, 2020 Accepting new patients

Locations

2060 Brighton Henrietta Town Line Rd
Rochester, NY 14623
Phone (585) 271-0660

Organizations & group practices 1

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1164786729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 BRIGHTON HENRIETTA TOWN LINE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232792",
            "telephone_number": "585-271-0661",
            "fax_number": "585-244-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 BRIGHTON HENRIETTA TOWN LINE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232792",
            "telephone_number": "585-271-0661",
            "fax_number": "585-244-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "KAYLEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.