Kathleen Mattoon Vanderbrook, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F300815 Issued in NY

Practice address

4 Coulter Rd Ste 1680
Clifton Springs, NY 14432-1122

Phone

(315) 906-4059

Fax

(315) 906-4132

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Clifton Springs Sanitarium CoGroup PAC ID 5092704809, 230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clifton Springs Hospital and Clinic Hospital, Clifton Springs, NY, CCN 330265
• Rochester General Hospital Hospital, Rochester, NY, CCN 330125
• Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030

Merit-based Incentive Payment System (MIPS)

Final score

96.62 of 100Reported as apm

Quality

74.51

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.62 of 100Reported as apm

Quality

74.51

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.62 of 100Reported as apm

Quality

74.51

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvanderbrook86015@direct.rochesterregional.org

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.

• Clifton Springs Sanitarium Co

  • General Acute Care Hospital
  • Clifton Springs, NY
  • NPI 1366505463
  Medicare reassignment Care Compare group NPD
• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment Care Compare group NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment Care Compare group NPD
• Finger Lakes Infectious Diseases, PLLC

  • Infectious Disease Physician
  • Pittsford, NY
  • NPI 1760711576
  Medicare reassignment NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• Rochester General Hospital

  • Internal Medicine Physician
  • Sodus, NY
  • NPI 1821163718
  NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clifton Springs Sanitarium Co

  • General Acute Care Hospital
  • Clifton Springs, NY
  • NPI 1366505463
  Care Compare affiliation
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1346369212
  Care Compare affiliation
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1770671182
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1255340782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 652",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-7741",
            "fax_number": "585-244-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COULTER RD STE 1680",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-906-4059",
            "fax_number": "315-906-4132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Hagen Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252666",
            "country_code": "US",
            "telephone_number": "585-922-5300",
            "fax_number": "585-922-0450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "165 E Union St Ste 327",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131557",
            "country_code": "US",
            "telephone_number": "315-359-2661",
            "fax_number": "315-331-6820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Pre Emption Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562042",
            "country_code": "US",
            "telephone_number": "315-759-5320",
            "fax_number": "315-350-3971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Elmwood Ave",
            "address_2": "Box 652",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-7741",
            "fax_number": "585-244-4320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBROOK",
        "first_name": "KATHLEEN",
        "middle_name": "MATTOON",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01545275",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvanderbrook86015@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "20 Hagen Dr Ste 120",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146252666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michele G Tyman, RN
• Susan Ullrich, RN CDE
• Delacey Jane Underhill, LMSW
• Vanderbrook Chiropractic
• Gregory Vanderbrook, D.C.
• Shelby Vanderbrook, LAC
• Samantha Hope Vitale, MSW
• Amanda Walters, LMT
• Wayne-Clifton Pharmacy Inc.
• Kimberly Moore Wesley, ANP

• Adult Health Nurse Practitioner in Clifton Springs, NY
• Providers in Clifton Springs, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.