Active NPI
Kelsey Roberts, DC
- Chiropractor
- Rochester, NY
National Provider Identifier
1902464670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 013191
- Practice address
- 309 Exchange Blvd
Rochester, NY 14608-2708 - Phone
- (315) 271-9434
- NPI assigned
- May 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 013191 | NY | Primary |
Addresses
Primary practice location
309 Exchange Blvd
Rochester, NY 14608-2708
Mailing address
283 Laburnam Cres
Rochester, NY 14620-1823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700082237 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529000210 | NY | Practitioner - Chiropractic | 8820419807 | Practice locations: Clinton, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
54 Dwight Ave
Clinton, NY 13323-1604
Phone (315) 853-6225
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013191 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Tucciarone D.C. | Chiropractor | Past | Accepting new patients |
Interoperability endpoints
- kelseyer@hiemail.healtheconnections.org
Organizations & group practices 1
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.
-
- Chiropractor
- Clinton, NY
- NPI 1346419512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1902464670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "283 LABURNAM CRES",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146201823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 EXCHANGE BLVD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146082708",
"telephone_number": "315-271-9434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KELSEY",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NY",
"license": "013191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700082237",
"state": "NY"
}
],
"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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.