Individual provider Active NPI

Robert George Ungeheuer, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1023057692
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001673-1 Issued in NY
Practice address
1971 Western Ave
Albany, NY 12203-5066
Phone
(518) 452-2597
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3529 FL
Physician Assistant 363A00000X 001673-1 NY Primary

Addresses

Primary practice location

1971 Western Ave
Albany, NY 12203-5066

Mailing address

1160 Chili Ave
Suite 200
Rochester, NY 14624-3035
Phone (585) 426-4990

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029000944 NY Practitioner - Physician Assistant 0244231108 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delphi Hospitalist Services LLCGroup PAC ID 5395819478, 49 clinicians

Practice addresses (Care Compare)

191 N Main St
Wellsville, NY 14895-1150
Phone (585) 593-1100

Hospital & facility affiliations

  • Carthage Area Hospital, Inc Hospital, Carthage, NY, CCN 331318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
001673NYMDInternal Medicine Physician
001673-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Area Hospital Inc CurrentSince Feb 1, 2019 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Carthage Area Hospital Inc CurrentSince Feb 1, 2019 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Emergency Medicine of Florida, Inc. Past Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

1001 West St
Carthage, NY 13619
Phone (315) 493-1000

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Organizations & group practices 8

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 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1023057692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 CHILI AVE",
            "address_2": "SUITE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243035",
            "telephone_number": "585-426-4990",
            "fax_number": "585-426-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035066",
            "telephone_number": "518-452-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGEHEUER",
        "first_name": "ROBERT",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3529",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "001673-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.