Individual provider Active NPI

Kathleen B McCullough, NP

  • Acute Care Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1508106709
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430654-1 Issued in NY
Practice address
1000 South Ave
Rochester, NY 14620-2733
Phone
(585) 341-6780
Fax
(585) 341-8489
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 430654 NY
Acute Care Nurse Practitioner 363LA2100X F430654-1 NY Primary

Addresses

Primary practice location

1000 South Ave
Rochester, NY 14620-2733

Mailing address

Box 679-B
601 Elmwood Ave.
Rochester, NY 14642-0001
Phone (585) 341-6780

Other names 1

  • Kathleen A Bryant Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmccullough45395@direct.urmc.rochester.edu Direct
Direct Messaging Address kmccullough45395@direct.urmc.rochester.edu 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
I20130725000722 NY Practitioner - Nurse Practitioner 2365683869 Reassigns benefits to 1 organization

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
Highland Hospital of RochesterGroup PAC ID 5496641631, 403 clinicians

Practice addresses (Care Compare)

1000 S Ave
Rochester, NY 14620-2733
Phone (585) 341-6776

Merit-based Incentive Payment System (MIPS)

Final score
89.84 of 100Reported as group
Quality
68.36
Promoting interoperability
100
Improvement activities
40
Cost
81.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F430654-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Jan 5, 2018 Accepting new patients
Highland Hospital of Rochester CurrentSince Jan 5, 2018 Accepting new patients

Locations

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

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

1000 South Ave
#58
Rochester, NY 14620
Phone (585) 341-6776

Organizations & group practices 2

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": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1508106709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 679-B",
            "address_2": "601 ELMWOOD AVE.",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-341-6780",
            "fax_number": "585-341-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-341-6780",
            "fax_number": "585-341-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KATHLEEN",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "430654",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430654-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccullough45395@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccullough45395@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BRYANT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.