NPIMap

Individual provider Active NPI

Kim K Petrone, MD

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1518946599
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
215418 Issued in NY
Practice address
1500 Portland Avenue
St Anns Community
Rochester, NY 14621
Phone
(585) 697-6415
Fax
(585) 342-9166
NPI assigned
Jan 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 215418 NY Primary

Addresses

Primary practice location

1500 Portland Avenue
St Anns Community
Rochester, NY 14621

Mailing address

1500 Portland Avenue
St Anns Community
Rochester, NY 14621
Phone (585) 697-6415

Other identifiers 3

IdentifierTypeStateIssuer
RA6962OtherHERITAGE
02309617MedicaidNY
108690BJOtherPREFERRED CARE HERT SAH S

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000264 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8820068331 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Rochester School of Medicine and Dentistry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anns Home for the AgedGroup PAC ID 5092758938, 11 clinicians
St Anns Nursing Home Company, IncGroup PAC ID 7517908635, 4 clinicians

Practice addresses (Care Compare)

1500 Portland Ave
Rochester, NY 14621-3065
Phone (585) 342-1700

920 Cherry Ridge Blvd
Webster, NY 14580-4801
Phone (585) 697-6337

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215418NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Ann's Home for the Aged CurrentSince Mar 1, 2005 Accepting new patients
The Church Home of the Protestant Episcopal Church in the City of Roch Current Accepting new patients
St. Ann's Nursing Home Company, Inc CurrentSince Mar 1, 2005 Accepting new patients
Wound Care Medical Associates PC CurrentSince May 9, 2017 Accepting new patients
St Anns Home for the Aged CurrentSince Mar 1, 2005 Accepting new patients
Community Hospital Medical Group Past Accepting new patients

Locations

920 Cherry Ridge Blvd
Webster, NY 14580
Phone (585) 697-6337

Interoperability endpoints

  • Direct secure messaging: kimpetrone@eslc.netsmartdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Anns Nursing Home Company, IncWebster, NY, CCN 335730 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 9, 2018
Feb 9, 2018
St Anns Home for the AgedRochester, NY, CCN 335081001 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 9, 2018
Feb 9, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1518946599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "address_2": "ST ANNS COMMUNITY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-697-6415",
            "fax_number": "585-342-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "address_2": "ST ANNS COMMUNITY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-697-6415",
            "fax_number": "585-342-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONE",
        "first_name": "KIM",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "215418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HERITAGE",
            "identifier": "RA6962",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02309617",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE HERT SAH S",
            "identifier": "108690BJ",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.