Individual provider Active NPI

Caitlin Mucenski

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1194223917
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402799 Issued in NY
Practice address
1099 Jay Street
Building J, Suite 202
Rochester, NY 14611
Phone
(315) 244-1935
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 716580 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402799 NY Primary

Addresses

Primary practice location

1099 Jay Street
Building J, Suite 202
Rochester, NY 14611

Mailing address

1099 Jay Street
Building J, Suite 202
Rochester, NY 14611
Phone (315) 244-1935

Other practice location 1

87 N Clinton Ave
Rochester, NY 14604-1455
Phone (585) 546-7220 ext. 5609

Other practice location 2

87 N Clinton Ave
Rochester, NY 14604-1455
Phone (585) 546-7220 ext. 5609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
716580NYMDPsychiatric/Mental Health Registered Nurse
402799NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villa of Hope CurrentSince Nov 18, 2021 Accepting new patients

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": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1194223917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 JAY STREET",
            "address_2": "BUILDING J, SUITE 202",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14611",
            "telephone_number": "315-244-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 JAY STREET",
            "address_2": "BUILDING J, SUITE 202",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14611",
            "telephone_number": "315-244-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 N Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146041455",
            "country_code": "US",
            "telephone_number": "585-546-7220 x5609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 N Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146041455",
            "country_code": "US",
            "telephone_number": "585-546-7220 x5609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUCENSKI",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "716580",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.