Individual provider Active NPI

Kaitlin Ann McKinley

  • Nurse Practitioner
  • Waterloo, NY
National Provider Identifier
1427824622
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
432849 Issued in NY
Practice address
369 E Main St
Waterloo, NY 13165-1654
Phone
(315) 787-4733
Fax
(315) 835-7101
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 432849 NY Primary

Addresses

Primary practice location

369 E Main St
Waterloo, NY 13165-1654

Mailing address

1460 Wilson Rd
Macedon, NY 14502-8933
Phone (607) 368-3127

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
I20240111002451 NY Practitioner - Nurse Practitioner 2264883487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mill Basin Medical Health PCGroup PAC ID 9133566128, 104 clinicians
FLH Medical PCGroup PAC ID 6507922358, 47 clinicians

Practice addresses (Care Compare)

1583 E 66TH St
FL 1
Brooklyn, NY 11234-6005
Phone (646) 296-1508

418 N Main St
Penn Yan, NY 14527-1070
Phone (315) 787-4733

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
432849NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical, PC CurrentSince Sep 1, 2025 Accepting new patients
Mill Basin Medical Health PC CurrentSince Apr 2, 2024 Accepting new patients
FLH Medical, PC CurrentSince Sep 1, 2025 Accepting new patients
Nys Medical Associate PLLC CurrentSince Jan 5, 2024 Accepting new patients

Locations

257 State St
Batavia, NY 14020
Phone (585) 343-1300

1583 E 66th St
#1
Brooklyn, NY 11234
Phone (917) 318-4724

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

45 Mason St
Geneva, NY 14456
Phone (315) 787-4733

75 Mason St
Geneva, NY 14456
Phone (315) 787-4733

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

48 Frost Ln
Unit A
Lawrence, NY 11559
Phone (516) 587-9960

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

300 Community Dr
Plandome, NY 11030

425 Beach Ave
Rochester, NY 14612
Phone (585) 663-0930

28 Cayuga St
Seneca Falls, NY 13148
Phone (315) 568-4415

369 E Main St
Waterloo, NY 13165
Phone (315) 539-4025

14310 20th Ave
Whitestone, NY 11357
Phone (718) 961-1212

Organizations & group practices 4

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1427824622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WILSON RD",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "145028933",
            "telephone_number": "607-368-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651654",
            "telephone_number": "315-787-4733",
            "fax_number": "315-835-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "KAITLIN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "432849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, NY

Sources for this page

Verify at the official NPI Registry.