Individual provider Active NPI

Rebecca Kavanaugh, FNP

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1215747357
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355406 Issued in NY
Practice address
10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone
(585) 275-5321
NPI assigned
Jan 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355406 NY Primary

Addresses

Primary practice location

10 Miracle Mile Dr
Rochester, NY 14623-5851

Mailing address

10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone (585) 275-5321

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
I20250922001337 NY Practitioner - Nurse Practitioner 8022512052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Elmwood Ave Box
Rochester, NY 14642-0001
Phone (585) 275-5321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Associates of Rochester CurrentSince Jul 14, 2025 Accepting new patients
University Orthopaedic Associates of Rochester Current Accepting new patients
University Orthopaedic Associates of Rochester CurrentSince Jul 14, 2025 Accepting new patients

Locations

10 Miracle Mile Dr
Rochester, NY 14623
Phone (585) 272-7240

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

Interoperability endpoints

  • Direct secure messaging: rkavanaugh97775@direct.urmc.rochester.edu

Organizations & group practices 3

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": "1736467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1215747357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MIRACLE MILE DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235851",
            "telephone_number": "585-275-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MIRACLE MILE DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235851",
            "telephone_number": "585-275-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "REBECCA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.