Individual provider Active NPI

Kaitlin Marie Smiley, NP

  • Family Nurse Practitioner
  • Penfield, NY
National Provider Identifier
1790443463
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F348509-01 Issued in NY
Practice address
43 Willow Pond Way Ste 200
Penfield, NY 14526-2638
Phone
(585) 377-5420
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F348509-01 NY Primary

Addresses

Primary practice location

43 Willow Pond Way Ste 200
Penfield, NY 14526-2638

Mailing address

43 Willow Pond Way Ste 200
Penfield, NY 14526-2638
Phone (585) 377-5420

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
I20211221001491 NY Practitioner - Nurse Practitioner 0648661942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highlands Womens HealthGroup PAC ID 8426283623, 35 clinicians

Practice addresses (Care Compare)

990 S Ave
Suite 103
Rochester, NY 14620-2740
Phone (585) 341-0101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F348509-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Womens Health CurrentSince Jul 15, 2024 Accepting new patients
Rochester General Hospital PastSince Dec 5, 2021 Accepting new patients

Locations

800 Ayrault Rd
Ste 100
Fairport, NY 14450
Phone (585) 602-0440

1000 South Ave
#116
Rochester, NY 14620
Phone (585) 341-6734

909 Culver Rd
Ste 2B
Rochester, NY 14609
Phone (585) 276-9388

909 Culver Rd
Rochester, NY 14609
Phone (585) 275-7892

990 South Ave
Ste 103
Rochester, NY 14620
Phone (585) 232-3210

Interoperability endpoints

  • Direct secure messaging: ksmiley95551@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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1790443463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WILLOW POND WAY STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262638",
            "telephone_number": "585-377-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WILLOW POND WAY STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262638",
            "telephone_number": "585-377-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F348509-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.