Individual provider Active NPI

Jaclyn Grode, MD

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1053061689
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
326269 Issued in NY
Practice address
777 Clinton Ave S
Rochester, NY 14620-1448
Phone
(585) 279-4800
Fax
(585) 442-8319
NPI assigned
Mar 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 326269 NY Primary

Addresses

Primary practice location

777 Clinton Ave S
Rochester, NY 14620-1448

Mailing address

777 Clinton Ave S
Rochester, NY 14620-1448
Phone (585) 279-4800

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
I20250806004156 NY Practitioner - Family Practice 3870978216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Hospital of RochesterGroup PAC ID 5496641631, shared by 4 NPIs, 403 clinicians

Practice addresses (Care Compare)

1000 S Ave
Rochester, NY 14620-2733
Phone (585) 473-2200

777 Clinton Ave S
Rochester, NY 14620-1448
Phone (585) 279-4680

Hospital & facility affiliations

  • Highland Hospital Hospital, Rochester, NY, CCN 330164
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Jul 1, 2025 Accepting new patients
Highland Hospital of Rochester CurrentSince Jul 1, 2025 Accepting new patients
Highland Hospital of Rochester CurrentSince Aug 17, 2025 Accepting new patients
Highland Hospital of Rochester Family Medicine Past Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

601 Elmwood Ave
#320
Rochester, NY 14642

777 Clinton Ave S
Rochester, NY 14620
Phone (585) 279-4790

Interoperability endpoints

  • Direct secure messaging: jgrode268998@direct.urmc.rochester.edu

Organizations & group practices 4

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 3

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": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1053061689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201448",
            "telephone_number": "585-279-4800",
            "fax_number": "585-442-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201448",
            "telephone_number": "585-279-4800",
            "fax_number": "585-442-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODE",
        "first_name": "JACLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-26",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "326269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.