Individual provider Active NPI

Colleen E Johnson

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1942471164
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335538 Issued in NY
Practice address
2440 Ridgeway Ave
Suite 100
Rochester, NY 14626-4145
Phone
(585) 720-1550
Fax
(585) 720-1553
NPI assigned
Mar 14, 2008
Last updated
Mar 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 520245-1 NY
Family Nurse Practitioner 363LF0000X 335538 NY Primary

Addresses

Primary practice location

2440 Ridgeway Ave
Suite 100
Rochester, NY 14626-4145

Mailing address

2440 Ridgeway Ave
Suite 100
Rochester, NY 14626-4145
Phone (585) 720-1550

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
I20080802000068 NY Practitioner - Nurse Practitioner 4183798572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Rochester, LLPGroup PAC ID 1557342185, 8 clinicians

Practice addresses (Care Compare)

2440 Ridgeway Ave
Suite 100
Rochester, NY 14626-4114
Phone (585) 720-1550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
520245-1NYMDRegistered Nurse
335538NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Rochester, LLP CurrentSince Jun 19, 2008 Accepting new patients

Locations

2440 Ridgeway Ave
#100
Rochester, NY 14626

2440 Ridgeway Ave
Ste 100
Rochester, NY 14626
Phone (585) 720-1550

Interoperability endpoints

  • Direct secure messaging: cjohnson@rocgastro.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1942471164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 RIDGEWAY AVE",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264145",
            "telephone_number": "585-720-1550",
            "fax_number": "585-720-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 RIDGEWAY AVE",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264145",
            "telephone_number": "585-720-1550",
            "fax_number": "585-720-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COLLEEN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "520245-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.