Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kellyrose Mary Nichols, DO

Individual provider Family Medicine Physician · NPI 1013274638

Dr. Kellyrose Mary Nichols, DO is a Family Practice in Le Roy, New York. Graduated from Philadelphia College of Osteopathic Medicine in 2012, 14 years ago. Practices with University of Rochester, a 962-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
NY
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

8745 Lake Street Rd
Le Roy, NY 14482-9344
Phone: (585) 768-2620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 279405 (NY)

Record details

NPI number1013274638
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 20, 2012
Last updated in NPPESJune 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2012 (14 years in practice)
Group practice University Of Rochester — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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