Individual provider Active NPI

Mary Victorious, CNM

  • Advanced Practice Midwife
  • Auburn, NY
National Provider Identifier
1255942017
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
002322 Issued in NY
Practice address
143 North St Ste 2
Auburn, NY 13021-1852
Phone
(315) 252-5028
Fax
(315) 252-1587
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 795713 NY
Advanced Practice Midwife 367A00000X 002322 NY Primary

Addresses

Primary practice location

143 North St Ste 2
Auburn, NY 13021-1852

Mailing address

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7011

Other names 1

  • Mary Kendt Former name

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
I20241203004433 NY Practitioner - Certified Nurse Midwife (CNM) 4880120690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
State University of New York at Stony Brook, School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians
University OB/GYN AssociatesGroup PAC ID 9133117740, 36 clinicians

Practice addresses (Care Compare)

143 N St
Suite 2
Auburn, NY 13021-1852
Phone (315) 252-5028

90 Presidential PLZ
FL 1
Syracuse, NY 13202-2244
Phone (315) 464-5210

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
795713NYMDRegistered Nurse
002322NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Jan 3, 2026 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jan 3, 2026 Accepting new patients
Auburn Community Hospital CurrentSince Jan 3, 2026 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jan 3, 2026 Accepting new patients
University OB/GYN Associates CurrentSince Jan 1, 2025 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

17 Lansing St
Ste 201
Auburn, NY 13021
Phone (315) 252-7434

143 North St
Ste 2
Auburn, NY 13021
Phone (315) 252-5028

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

90 Presidential Plz
Fl 1
Syracuse, NY 13202
Phone (315) 464-5210

Interoperability endpoints

  • Direct secure messaging: mkendt163003@direct.upstate.edu

Organizations & group practices 5

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1255942017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7011",
            "fax_number": "315-255-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 NORTH ST STE 2",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211852",
            "telephone_number": "315-252-5028",
            "fax_number": "315-252-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIOUS",
        "first_name": "MARY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "795713",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "002322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KENDT",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.