Individual provider Active NPI

Farokh Foroozesh, MD

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1053379859
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
118603 Issued in NY
Practice address
370 E Ridge Rd
Rochester, NY 14621-1240
Phone
(585) 922-0600
NPI assigned
May 2, 2006
Last updated
May 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 118603 NY Primary

Addresses

Primary practice location

370 E Ridge Rd
Rochester, NY 14621-1240

Mailing address

370 E Ridge Rd
Rochester, NY 14621-1240
Phone (585) 922-0600

Other identifiers 2

IdentifierTypeStateIssuer
110244048OtherNYMEDICARE RAILROAD #
118603-0BOtherNYWORKERS COMP #

Other names 1

  • Farokh Foroozesh-Banej Former name

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
I20071024000164 NY Practitioner - Internal Medicine 7416043302 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118603NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Oct 1, 2007 Accepting new patients
Rochester General Hospital Internal Medicine Current Accepting new patients

Locations

77 Sullys Trl
Ste 100
Pittsford, NY 14534
Phone (585) 424-6210

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1425 Portland Ave
Bldg 1
Rochester, NY 14621
Phone (585) 338-1400

370 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-0400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1053379859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211240",
            "telephone_number": "585-922-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211240",
            "telephone_number": "585-922-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROOZESH",
        "first_name": "FAROKH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "118603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD #",
            "identifier": "110244048",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP #",
            "identifier": "118603-0B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAROKH",
            "last_name": "FOROOZESH-BANEJ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.