Individual provider Active NPI

Kelly Ann Probst, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1558971812
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025340 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-1348
Phone
(585) 276-3000
NPI assigned
Aug 3, 2020
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025340 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-1348

Mailing address

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 276-3000

Other practice location 1

136 Seminole Way
Rochester, NY 14618-1348
Phone (585) 626-7847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240419001782 TN Practitioner - Physician Assistant 6507271962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4741TNMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System Inc CurrentSince Apr 1, 2024 Accepting new patients
University Health System, Inc Physician Assistant CurrentSince Apr 1, 2024 Accepting new patients
Knoxville Neurology Specialists, PLLC Past Accepting new patients

Locations

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

1924 Alcoa Hwy
#56
Knoxville, TN 37920
Phone (865) 305-9081

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1558971812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146421348",
            "telephone_number": "585-276-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Seminole Way",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146181348",
            "country_code": "US",
            "telephone_number": "585-626-7847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROBST",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.