Individual provider Active NPI

Kelly Jo Gursslin, FNP - C

  • Family Nurse Practitioner
  • Penfield, NY
National Provider Identifier
1972916799
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338562-1 Issued in NY
Practice address
2200 Penfield Rd
Penfield, NY 14526-1711
Phone
(585) 922-0460
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 F338562-1 NY Primary

Addresses

Primary practice location

2200 Penfield Rd
Penfield, NY 14526-1711

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-1900

Other practice location 1

560 White Spruce Blvd
Rochester, NY 14623-1613
Phone (585) 258-7948

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
I20150429001407 NY Practitioner - Nurse Practitioner 6406175231 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

  • Rochester Regional Health Home Care Home health agency, Rochester, NY, CCN 337066
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F338562-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jan 1, 2018 Accepting new patients
Lattimore Primary Care Medicine, PLLC CurrentSince Mar 1, 2015 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2018 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2018 Accepting new patients

Locations

2200 Penfield Rd
Penfield, NY 14526
Phone (585) 377-6170

1425 Portland Ave
Bldg 1
Rochester, NY 14621
Phone (585) 338-1400

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

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

560 White Spruce Blvd
Rochester, NY 14623
Phone (585) 271-5250

1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623
Phone (585) 287-5622

Interoperability endpoints

  • Direct secure messaging: kgursslin225483@direct.rochesterregional.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1972916799",
    "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",
            "telephone_number": "585-922-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PENFIELD RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261711",
            "telephone_number": "585-922-0460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 White Spruce Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146231613",
            "country_code": "US",
            "telephone_number": "585-258-7948",
            "fax_number": "585-271-6132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURSSLIN",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "FNP - C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338562-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.