Individual provider Active NPI

Jennifer Pauline Krossber

  • Registered Nurse
  • Rochester, NY
National Provider Identifier
1366085110
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
610118-1 Issued in NY
Practice address
1000 Elmwood Ave Ste 100
Rochester, NY 14620-3042
Phone
(585) 271-0761
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 610118-1 NY Primary

Addresses

Primary practice location

1000 Elmwood Ave Ste 100
Rochester, NY 14620-3042

Mailing address

7770 State Route 5 and 20
Bloomfield, NY 14469-9352
Phone (585) 755-3148

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
610118-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1366085110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7770 STATE ROUTE 5 AND 20",
            "city": "BLOOMFIELD",
            "state": "NY",
            "postal_code": "144699352",
            "telephone_number": "585-755-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203042",
            "telephone_number": "585-271-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROSSBER",
        "first_name": "JENNIFER",
        "middle_name": "PAULINE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "610118-1",
            "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 Oct 24, 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.