Individual provider Active NPI

Carrie B Martineau, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1447097092
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
312005 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4164
Phone
(585) 723-7870
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 585058 NY
Adult Health Nurse Practitioner 363LA2200X F312005-01 NY
Gerontology Nurse Practitioner 363LG0600X 312005 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4164

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

224 Round Pond Ln
Rochester, NY 14626-1731
Phone (719) 641-4946

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmartineau226024@direct.rochesterregional.org 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
I20241120000858 NY Practitioner - Nurse Practitioner 9436684081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-4000

Hospital & facility affiliations

  • Unity Hospital Hospital, Rochester, NY, CCN 330226

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
585058NYMDRegistered Nurse
F312005-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Nov 4, 2024 Accepting new patients
Rochester General Hospital CurrentSince Nov 4, 2024 Accepting new patients
Rochester General Hospital CurrentSince Nov 4, 2024 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital Current Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: cmartineau226024@direct.rochesterregional.org

Organizations & group practices 5

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 7

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": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1447097092",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264164",
            "telephone_number": "585-723-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Round Pond Ln",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146261731",
            "country_code": "US",
            "telephone_number": "719-641-4946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEAU",
        "first_name": "CARRIE",
        "middle_name": "B",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "585058",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F312005-01",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "312005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmartineau226024@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1555 Long Pond Rd",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146264164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.