Individual provider Active NPI

Renee T Ross, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Mount Kisco, NY
National Provider Identifier
1891672192
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
356952 Issued in NY
Practice address
110 S Bedford Rd
Mount Kisco, NY 10549-3446
Phone
(914) 666-7171
NPI assigned
Aug 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 356952 NY Primary

Addresses

Primary practice location

110 S Bedford Rd
Mount Kisco, NY 10549-3446

Mailing address

24 Dunston Ave
Yonkers, NY 10701-6321
Phone (347) 330-9093

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
I20251112003030 NY Practitioner - Nurse Practitioner 3678064169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

110 S Bedford Rd
Mount Kisco, NY 10549-3446
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
356952NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Dec 1, 2025 Accepting new patients
Optum Medical Care, P.C. CurrentSince Dec 1, 2025 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1891672192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DUNSTON AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107016321",
            "telephone_number": "347-330-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-666-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "RENEE",
        "middle_name": "T",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.