Individual provider Active NPI

Kent M Weisbeck, ATC, LICENSED

  • Athletic Trainer
  • Rochester, NY
National Provider Identifier
1841264504
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000405-1 Issued in NY
Practice address
1 War Memorial SQ
Rochester, NY 14614-2109
Phone
(585) 454-5335
Fax
(585) 454-3954
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 000405-1 NY Primary

Addresses

Primary practice location

1 War Memorial SQ
Rochester, NY 14614-2109

Mailing address

36 Mayfair Dr
Rochester, NY 14617-3507
Phone (585) 338-9471

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

State licenses

LicenseStateTypeSpecialty
000405-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1841264504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MAYFAIR DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146173507",
            "telephone_number": "585-338-9471",
            "fax_number": "585-338-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAR MEMORIAL SQ",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146142109",
            "telephone_number": "585-454-5335",
            "fax_number": "585-454-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBECK",
        "first_name": "KENT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "ATC, LICENSED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000405-1",
            "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 13, 2026; 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.