Individual provider Active NPI

Kayla R Fazi, RN

  • Medical-Surgical Registered Nurse
  • Rochester, NY
National Provider Identifier
1649572801
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
673786 Issued in NY
Practice address
12 Mia Ter
Rochester, NY 14624-4453
Phone
(585) 698-8569
NPI assigned
Nov 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 673786 NY Primary

Addresses

Primary practice location

12 Mia Ter
Rochester, NY 14624-4453

Mailing address

481 French Rd
Rochester, NY 14618-5374
Phone (585) 698-8569

Other practice location 1

481 French Rd
Rochester, NY 14618-5374
Phone (585) 698-8569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
673786NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1290297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1649572801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 FRENCH RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185374",
            "telephone_number": "585-698-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MIA TER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146244453",
            "telephone_number": "585-698-8569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "481 French Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146185374",
            "country_code": "US",
            "telephone_number": "585-698-8569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZI",
        "first_name": "KAYLA",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-21",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "673786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.