Individual provider Active NPI

Amel Rassoul, DMD

  • Dentist
  • Rochester, NY
National Provider Identifier
1013579192
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
061174 Issued in NY
Practice address
1841 W Ridge Rd
Rochester, NY 14615-2504
Phone
(585) 225-7700
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 061174 NY Primary

Addresses

Primary practice location

1841 W Ridge Rd
Rochester, NY 14615-2504

Mailing address

62 Raleigh St
Rochester, NY 14620-4120
Phone (514) 962-1377

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250707003534 NY Order and Referring Only - DentistPractitioner - Dentist 8325552938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1013579192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 RALEIGH ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204120",
            "telephone_number": "514-962-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 W RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152504",
            "telephone_number": "585-225-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSOUL",
        "first_name": "AMEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "061174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.