NPIMap

Individual provider Active NPI

Kelcie Sprentall

  • Family Medicine Physician
  • Canandaigua, NY
National Provider Identifier
1891182960
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
319177 Issued in NY
Practice address
401 S Main St Ste 200
Canandaigua, NY 14424-2157
Phone
(585) 394-1875
Fax
(585) 394-1878
NPI assigned
Apr 16, 2015
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD464217 PA
Family Medicine Physician 207Q00000X 319177 NY Primary

Addresses

Primary practice location

401 S Main St Ste 200
Canandaigua, NY 14424-2157

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksprentall363457@direct.rochesterregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230214002747 NY Practitioner - Family Practice 4587968813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
319177NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Family Medicine CurrentSince Feb 13, 2023 Accepting new patients
Rochester General Hospital CurrentSince May 1, 2025 Accepting new patients
Rochester General Hospital Family Medicine CurrentSince May 1, 2025 Accepting new patients
Valley View Family Practice Associates, LLP Family Medicine PastSince Feb 1, 2023 Accepting new patients

Locations

401 S Main St
Ste 200
Canandaigua, NY 14424
Phone (585) 394-1875

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

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1891182960",
    "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": "401 S MAIN ST STE 200",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144242157",
            "telephone_number": "585-394-1875",
            "fax_number": "585-394-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRENTALL",
        "first_name": "KELCIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD464217",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "319177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksprentall363457@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 S Main St Ste 200",
            "city": "Canandaigua",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144242157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.