Individual provider Active NPI

Kimberly Corey Trombly, NP

  • Acute Care Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1780849521
Registry record updated Apr 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430174 Issued in NY
Practice address
300 Crittenden Boulevard Box Psych
Rochester, NY 14642-0001
Phone
(585) 275-3569
Fax
(585) 273-1384
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 430174 NY
Acute Care Nurse Practitioner 363LA2100X F430174 NY Primary

Addresses

Primary practice location

300 Crittenden Boulevard Box Psych
Rochester, NY 14642-0001

Mailing address

300 Crittenden Boulevard Box Psych
Rochester, NY 14642-0001
Phone (585) 275-3569

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2222

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
I20190517001818 NY Practitioner - Nurse Practitioner 5092037333 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430174NYMDAcute Care Nurse Practitioner
F430174NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Apr 8, 2020 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Apr 8, 2020 Accepting new patients
University of Rochester Current Accepting new patients

Locations

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

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

Interoperability endpoints

  • Direct secure messaging: kim.trombly.1@29290.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1780849521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BOULEVARD BOX PSYCH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3569",
            "fax_number": "585-273-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BOULEVARD BOX PSYCH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3569",
            "fax_number": "585-273-1384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROMBLY",
        "first_name": "KIMBERLY",
        "middle_name": "COREY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430174",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.