Individual provider Active NPI

Kyle Eric Munro, PA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1386111599
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025212 Issued in NY
Practice address
2561 Lac de Ville Blvd Ste 200
Rochester, NY 14618-5645
Phone
(585) 473-3900
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 25212 NY
Physician Assistant 363A00000X 025212 NY Primary

Addresses

Primary practice location

2561 Lac de Ville Blvd Ste 200
Rochester, NY 14618-5645

Mailing address

2561 Lac de Ville Blvd Ste 200
Rochester, NY 14618-5645
Phone (585) 473-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmunro251641@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
I20201008001597 NY Practitioner - Physician Assistant 0648690834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25212NYMDAddiction (Substance Use Disorder) Counselor
025212NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Group Health Association PastSince Mar 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kmunro251641@direct.urmc.rochester.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1386111599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 LAC DE VILLE BLVD STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185645",
            "telephone_number": "585-473-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2561 LAC DE VILLE BLVD STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185645",
            "telephone_number": "585-473-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNRO",
        "first_name": "KYLE",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2023-07-17",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "25212",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmunro251641@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.