Individual provider Active NPI

Kristine Kent

  • Psychologist
  • Rochester, NY
National Provider Identifier
1477988913
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023951 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3011
Phone
(585) 922-4698
Fax
(585) 922-5702
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 023951 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3011

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-4698

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608000351 NY Practitioner - Clinical Psychologist 9436559804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
023951NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jun 28, 2021 Accepting new patients
Rochester General Hospital CurrentSince Jun 28, 2021 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1477988913",
    "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": "585-922-4698",
            "fax_number": "585-922-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213011",
            "telephone_number": "585-922-4698",
            "fax_number": "585-922-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.