Individual provider Active NPI

Kyle Smith, MD

  • Physical Medicine & Rehabilitation Physician
  • Rochester, NY
National Provider Identifier
1184111643
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
315062 Issued in NY
Practice address
4901 Lac de Ville Blvd.
BLDG D, Suite 250
Rochester, NY 14618-5649
Phone
(585) 275-5321
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 315062 NY Primary
Child & Adolescent Psychiatry Physician 2084P0804X 315062 NY
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4901 Lac de Ville Blvd.
BLDG D, Suite 250
Rochester, NY 14618-5649

Mailing address

601 Elmwood Ave Box 664
Rochester, NY 14642-0001
Phone (585) 276-8394

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 276-8394

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksmith138028@direct.urmc.rochester.edu Direct
Direct Messaging Address ksmith138028@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220520001032 NY Practitioner - Physical Medicine and Rehabilitation 2264784198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Temple University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

4901 Lac de Ville Blvd
Suite 250
Rochester, NY 14618-5649
Phone (585) 275-3271

4901 Lac Deville Blvd
BLDG D Suite 250
Rochester, NY 14618-5647
Phone (585) 275-2530

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
315062NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jul 9, 2022 Accepting new patients
University of Rochester Physical Medicine and Rehabilitation Physical Medicine & Rehabilitation CurrentSince Jul 1, 2022 Accepting new patients
University of Rochester CurrentSince Jul 9, 2022 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester Current Accepting new patients
Hematology Clinical Group Current Accepting new patients

Locations

699 S Main St
Ste 3
Canandaigua, NY 14424
Phone (585) 602-1150

601 Elmwood Ave
#664
Rochester, NY 14642
Phone (585) 275-3271

4901 Lac de Ville Blvd
Ste 250
Rochester, NY 14618
Phone (585) 275-3271

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

5901 Lac de Ville Blvd
#250
Rochester, NY 14618
Phone (585) 275-3271

Interoperability endpoints

  • Direct secure messaging: ksmith138028@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 3

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1184111643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 664",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 LAC DE VILLE BLVD.",
            "address_2": "BLDG D, SUITE 250",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185649",
            "telephone_number": "585-275-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-276-8394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-07-17",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "315062",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "315062",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith138028@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": "ksmith138028@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.