KATIE ELIZABETH KENNY (NPI# 1225385305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225385305 |
| Entity Type | Individual |
| Full Name | KATIE ELIZABETH KENNY |
| Credential | PA |
| Practice Address |
1555 Long Pond Rd Fl 1 Rochester NY 14626-4122 |
| Mailing Address |
1555 Long Pond Road Department of Surgery Rochester NY 14626-4122 |
| Practice Telephone | 5857237000 |
| Practice Fax Number | 5857237280 |
| Mailing Telephone | 5857237225 |
| Mailing Fax Number | 5857237280 |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2019-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
015698 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03524476 | 05 | |
| NY | CAQH | 12434137 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1445 Portland Ave Ste 108, Rochester, NY 146213008 | 5859225550 | 5859225950 |
| 1425 Portland Ave, Rochester, NY 146213001 | 5859673104 |
| Street Address |
1555 LONG POND RD FL 1 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14626-4122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720563679 | Elizabeth A Kaltenbach | Physician Assistant | 1555 Long Pond Rd Fl 1, Rochester, NY 14626-4122 | 2018-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760978084 | Elizabeth M Neenan | Nurse Practitioner | 105 Canal Landing Blvd. Suite 1, Rochester, NY 14626 | 2018-07-10 |
| 1811488737 | Anthony Richard Mesolella | Dentist | 2081 W Ridge Rd Ste 204, Rochester, NY 14626 | 2018-05-26 |
| 1285157370 | Heather Kate Byam | Nurse Anesthetist, Certified Registered | 280 Mill Road, Rochester, NY 14626 | 2017-07-20 |
| 1710415039 | Abner O De Los Santos | Dentist | 120 Erie Canal Dr Ste 150, Rochester, NY 14626 | 2017-05-31 |
| 1609308709 | Ulfat Shafiq | Dentist | 1100 Long Pond Rd Ste 115, Greece, NY 14626 | 2017-03-29 |
| 1174982953 | S.a.v.o.c L.l.c | Preferred Provider Organization | 2833 West Ridge Road, Pearle Vision Ridgemont Plaza Suite 'a', Rochester, NY 14626 | 2016-02-22 |
| 1700244357 | Kerri Anne Sawyer | Registered Nurse | 82 Southridge Drive, Rochester, NY 14626 | 2016-02-10 |
| 1518398106 | Braces of Greece | Exclusive Provider Organization | 770 Fetzner Rd., Rochester, NY 14626 | 2013-12-06 |
| 1477983443 | Amy Pawlyk | Licensed Practical Nurse | 116 Annie Lane, Rochester, NY 14626 | 2013-11-12 |
| 1689911208 | Kathleen Zimmerman | Occupational Therapist | 1555 Long Pond Rd., 4th Floor, Rochester, NY 14626 | 2013-01-16 |
| Find all providers in zip 14626 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518411107 | Michelle Ann Swider | Physician Assistant | 1425 Portland Ave Ste 220, Rochester, NY 14621-3011 | 2016-08-11 |
| 1124423355 | Amanda Schnorf | Physician Assistant | 2824 W Ridge Rd, Rochester, NY 14626-1639 | 2014-10-30 |
| 1679989479 | Jacob William Raifstanger | Physician Assistant | 2655 Ridgeway Ave Ste 460, Rochester, NY 14626-4296 | 2014-07-01 |
| 1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
| 1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
| 1033322797 | Joan Marie Wobig | Physician Assistant | 5426 15th St Se, Rochester, MN 55904-6719 | 2007-05-08 |
| 1871705749 | Beverley Myers | Physician Assistant | 4730 17th St Se, Rochester, MN 55904-6680 | 2007-05-04 |
| 1831310739 | Brenda Gerdts | Physician Assistant | 4838 Scenic View Dr Sw, Rochester, MN 55902-1527 | 2007-05-01 |
| 1558419739 | Kathryn Ann Ciurca | Physician Assistant | 868 Clover St, Rochester, NY 14610-3232 | 2007-01-06 |
| 1245265594 | Margaret M Casper | Physician Assistant | 1445 Portland Ave Ste 210, Rochester, NY 14621-3008 | 2006-07-12 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.