Individual provider Active NPI

Kaitlyn Marie Locke, PNP

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1902570336
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383273 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-2375
NPI assigned
Aug 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 383273 NY
Pediatric Nurse Practitioner 363LP0200X 383273 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

12 County Fair Dr Apt 108
Rochester, NY 14623-4371
Phone (585) 472-2649

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kfales50241@direct.urmc.rochester.edu Direct
Direct Messaging Address kfales50241@direct.urmc.rochester.edu Direct

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
I20210823001990 NY Practitioner - Nurse Practitioner 5092110445 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
383273NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric G I Nutrition CurrentSince Aug 30, 2021 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester Internal Medicine CurrentSince Aug 30, 2021 Accepting new patients
Pediatric Group Univ of Rochester CurrentSince Jan 1, 2024 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 30, 2021 Accepting new patients
Pediatric Immun-Nephr-Rheumology CurrentSince Jan 1, 2024 Accepting new patients
Pediatric Group Univ of Rochester CurrentSince Jan 1, 2024 Accepting new patients
University of Rochester Internal Medicine Current Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#667
Rochester, NY 14642
Phone (585) 275-2647

601 Elmwood Ave
#635
Rochester, NY 14642
Phone (585) 275-2821

Organizations & group practices 9

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": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1902570336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COUNTY FAIR DR APT 108",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234371",
            "telephone_number": "585-472-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2023-07-17",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "383273",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfales50241@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfales50241@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.