Individual provider Active NPI

Robert H Oliver, M.D.

  • Otolaryngology Physician
  • Rochester, NY
National Provider Identifier
1003819368
Registry record updated Sep 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
211704-1 Issued in NY
Practice address
1295 Portland Ave
Ste. 24
Rochester, NY 14621-2731
Phone
(585) 342-2080
Fax
(585) 301-4037
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 211704-1 NY Primary

Addresses

Primary practice location

1295 Portland Ave
Ste. 24
Rochester, NY 14621-2731

Mailing address

1295 Portland Ave
Ste. 24
Rochester, NY 14621-2731
Phone (585) 342-2080

Other identifiers 1

IdentifierTypeStateIssuer
01915420MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000491 NY Practitioner - Otolaryngology 8325142268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1295 Portland Ave
Suite 24
Rochester, NY 14621-2720
Phone (585) 342-2080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
211704-1NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital PastSince Jul 10, 2006 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441411200000",
    "number": "1003819368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 PORTLAND AVE",
            "address_2": "STE. 24",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212731",
            "telephone_number": "585-342-2080",
            "fax_number": "585-301-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 PORTLAND AVE",
            "address_2": "STE. 24",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212731",
            "telephone_number": "585-342-2080",
            "fax_number": "585-301-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2015-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "211704-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01915420",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.