Individual provider Active NPI

Kelley P Monachino, PA-C

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1386714848
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
011526 Issued in NY
Practice address
2968 Chili Ave
Rochester, NY 14624-4532
Phone
(585) 207-0088
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011526 NY
Medical Physician Assistant 363AM0700X 011526 NY Primary

Addresses

Primary practice location

2968 Chili Ave
Rochester, NY 14624-4532

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 872-0650

Other practice location 1

45 Webster Commons Blvd Ste 200
Webster, NY 14580-3813
Phone (585) 872-0650

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
I20070712000334 NY Practitioner - Physician Assistant 8224138763 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011526NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C CurrentSince Jun 27, 2022 Accepting new patients
University of Rochester CurrentSince Dec 12, 2016 Accepting new patients
University of Rochester CurrentSince Dec 12, 2016 Accepting new patients
Rochester General Hospital CurrentSince Apr 1, 2020 Accepting new patients
Rochester General Hospital CurrentSince Apr 1, 2020 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jun 27, 2022 Accepting new patients
Island Medical Empire State, PLLC Physician Assistant Past Accepting new patients

Locations

2226 Penfield Rd
Penfield, NY 14526
Phone (585) 388-5280

2745 W Ridge Rd
Rochester, NY 14626
Phone (585) 225-5252

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

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

45 Webster Commons Blvd
#200
Webster, NY 14580
Phone (585) 872-0650

Organizations & group practices 11

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1386714848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-872-0650",
            "fax_number": "585-872-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 CHILI AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146244532",
            "telephone_number": "585-207-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Webster Commons Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "NY",
            "postal_code": "145803813",
            "country_code": "US",
            "telephone_number": "585-872-0650",
            "fax_number": "585-872-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONACHINO",
        "first_name": "KELLEY",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011526",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.