Individual provider Active NPI

Nancy Kwamboka Bosire

  • Registered Nurse
  • Rochester, NY
National Provider Identifier
1487540779
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
753691 Issued in NY
Practice address
2116 E Henrietta Rd
Rochester, NY 14623-4518
Phone
(085) 636-1346
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 753691 NY Primary

Addresses

Primary practice location

2116 E Henrietta Rd
Rochester, NY 14623-4518

Mailing address

46 Braunston Dr
Fairport, NY 14450-8739
Phone (085) 636-1346

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
I20251114002191 NY Practitioner - Nurse Practitioner 5597256826 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ilm Medical Care PLLCGroup PAC ID 2769610989, 37 clinicians

Practice addresses (Care Compare)

3 Upton Park
Rochester, NY 14607-1751
Phone (845) 738-8770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
753691NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Medical Services, PLLC CurrentSince Oct 1, 2025 Accepting new patients
Highland Hospital of Rochester CurrentSince Nov 17, 2025 Accepting new patients
Highland Hospital of Rochester CurrentSince Nov 17, 2025 Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

1024 Hilton Parma Rd
Hilton, NY 14468
Phone (585) 392-4114

3 Upton Park
Rochester, NY 14607
Phone (585) 241-2100

2116 E Henrietta Rd
Rochester, NY 14623
Phone (585) 204-0551

777 Clinton Ave S
Rochester, NY 14620
Phone (585) 279-4790

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.

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1487540779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 BRAUNSTON DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508739",
            "telephone_number": "085-636-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234518",
            "telephone_number": "085-636-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSIRE",
        "first_name": "NANCY",
        "middle_name": "KWAMBOKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "753691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.