NPIMap

Individual provider Active NPI

Kiersten Marie Vick, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1972956324
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019844 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-4122
Phone
(585) 275-4711
Fax
(585) 276-0101
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 019844 NY
Physician Assistant 363A00000X 019844 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-4122

Mailing address

601 Elmwood Avenue Box Med
Rochester, NY 14642-0001
Phone (585) 275-4711

Other practice location 1

1555 Long Pond Road
Department of Medicine
Rochester, NY 14626-4122
Phone (585) 723-7870

Other names 1

  • Kiersten Simmons Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161128000529 NY Practitioner - Physician Assistant 9537448063 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 429-2289

1565 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7366

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
019844NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Oct 1, 2016 Accepting new patients
Rochester General Hospital CurrentSince Jun 1, 2020 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
The Unity Hospital of Rochester CurrentSince Oct 1, 2016 Accepting new patients
University of Rochester CurrentSince Oct 1, 2019 Accepting new patients
University of Rochester CurrentSince Oct 1, 2019 Accepting new patients

Locations

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

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

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

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

Organizations & group practices 11

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 7

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1972956324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4711",
            "fax_number": "585-276-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146424122",
            "telephone_number": "585-275-4711",
            "fax_number": "585-276-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Long Pond Road",
            "address_2": "Department of Medicine",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264122",
            "country_code": "US",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICK",
        "first_name": "KIERSTEN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019844",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIERSTEN",
            "last_name": "SIMMONS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.