Individual provider Active NPI

Kelly Anne Steffen, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1760128581
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344950 Issued in NY
Practice address
1415 Portland Ave Ste 200
Rochester, NY 14621-3022
Phone
(585) 922-0390
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 688884 NY
Family Nurse Practitioner 363LF0000X 344950 NY Primary

Addresses

Primary practice location

1415 Portland Ave Ste 200
Rochester, NY 14621-3022

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

7376 State Route 31 Ste 1000
Lyons, NY 14489-9173
Phone (315) 560-4303

Other names 1

  • Kelly Anne Hennigan Former name

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
I20241125000970 NY Practitioner - Nurse Practitioner 4385179522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1415 Portland Ave
Rochester, NY 14621-3038
Phone (585) 922-0390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
688884NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Family CurrentSince Oct 14, 2024 Accepting new patients
Rochester General Hospital CurrentSince Oct 14, 2024 Accepting new patients
Rochester General Hospital Current Accepting new patients

Locations

1415 Portland Ave
Rochester, NY 14621
Phone (585) 275-7741

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 200
Rochester, NY 14621
Phone (585) 922-0390

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1760128581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213022",
            "telephone_number": "585-922-0390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7376 State Route 31 Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Lyons",
            "state": "NY",
            "postal_code": "144899173",
            "country_code": "US",
            "telephone_number": "315-560-4303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFFEN",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "688884",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "HENNIGAN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.