Individual provider Active NPI

Nicole Sangiacomo-Zollo, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1326686957
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383111 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-2100
NPI assigned
Dec 13, 2019
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 779443-01 NY
Pediatric Nurse Practitioner 363LP0200X 383111 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Rochester, NY 14642-0001

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nsangiacomo211859@direct.urmc.rochester.edu Direct
Direct Messaging Address nsangiacomo211859@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200918001453 NY Practitioner - Nurse Practitioner 6305264615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
779443-01NYMDPediatric Registered Nurse
383111NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Group Univ of Rochester CurrentSince Jun 6, 2020 Accepting new patients
Pediatric Group Univ of Rochester CurrentSince Jun 6, 2020 Accepting new patients
Pediatric Group Univ of Rochester Current Accepting new patients

Locations

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

601 Elmwood Ave
#320
Rochester, NY 14642

601 Elmwood Ave
#635
Rochester, NY 14642
Phone (585) 275-2821

601 Elmwood Ave
#777
Rochester, NY 14642
Phone (585) 275-0995

Interoperability endpoints

  • Direct secure messaging: nsangiacomo211859@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1326686957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGIACOMO-ZOLLO",
        "first_name": "NICOLE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "779443-01",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsangiacomo211859@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": "nsangiacomo211859@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.