Individual provider Active NPI

Justine Theresa Shults, NP

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1629432810
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307742 Issued in NY
Practice address
2365 Clinton Ave S
Ste 200
Rochester, NY 14618-2663
Phone
(585) 758-5700
Fax
(585) 758-1299
NPI assigned
Apr 13, 2016
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 307742 NY Primary
Family Nurse Practitioner 363LF0000X 307742 NY
Registered Nurse 163W00000X 593687-1 NY

Addresses

Primary practice location

2365 Clinton Ave S
Ste 200
Rochester, NY 14618-2663

Mailing address

2365 Clinton Ave S
Rochester, NY 14618-2663
Phone (585) 758-5700

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jshults46770@direct.urmc.rochester.edu Direct
Direct Messaging Address jshults46770@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
I20161122000659 NY Practitioner - Nurse Practitioner 9133408750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Miracle Mile Dr
Rochester, NY 14623-5851
Phone (585) 275-5321

601 Elmwood Ave
Rochester, NY 14642-0001

601 Elmwood Ave Box
Rochester, NY 14642-0001
Phone (585) 275-5321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
593687-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Associates of Rochester CurrentSince Apr 1, 2017 Accepting new patients
University Otolaryngology Associates CurrentSince Sep 24, 2016 Accepting new patients
University Orthopaedic Associates of Rochester CurrentSince Apr 1, 2017 Accepting new patients

Locations

2365 S Clinton Ave
Ste 200
Rochester, NY 14618
Phone (585) 275-0142

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

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

Interoperability endpoints

  • Direct secure messaging: jshults46770@direct.urmc.rochester.edu

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, 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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1629432810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182663",
            "telephone_number": "585-758-5700",
            "fax_number": "585-758-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 CLINTON AVE S",
            "address_2": "STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182663",
            "telephone_number": "585-758-5700",
            "fax_number": "585-758-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTS",
        "first_name": "JUSTINE",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307742",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "307742",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "593687-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshults46770@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": "jshults46770@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": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.