Organization Active NPI

Plastic Surgery Group of Rochester LLC

  • Plastic Surgery Physician
  • Rochester, NY
National Provider Identifier
1053403717
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY GROUP OF ROCHESTER LLC
Practice address
360 Linden Oaks Ste 310
Rochester, NY 14625-2814
Phone
(585) 922-5840
Fax
(585) 586-7558
NPI assigned
Sep 29, 2006
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Mrs. Gail J Edwards
Title
Practice Manager
Phone
(585) 249-1950

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X Primary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X

Addresses

Primary practice location

360 Linden Oaks Ste 310
Rochester, NY 14625-2814

Mailing address

360 Linden Oaks Ste 310
Rochester, NY 14625-2814
Phone (585) 922-5840

Other practice location 1

10 Hagen Dr
Suite 310
Rochester, NY 14625-2660
Phone (585) 922-5840

Other practice location 2

1445 Portland Ave Ste G-01
Rochester, NY 14621-3008
Phone (585) 922-5840

Other practice location 3

10 Hagen Dr
Suite 310
Rochester, NY 14625-2660
Phone (585) 922-5840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Timothy.OConnor@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040410000088 NY Part B Supplier - Clinic/Group Practice 9335133636 Receives reassigned benefits from 5 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

125 Red Creek Dr
Ste 206
Rochester, NY 14623
Phone (585) 359-1560

1445 Portland Ave
Ste G-01
Rochester, NY 14621
Phone (585) 922-5840

220 Alexander St
Ste 611
Rochester, NY 14607
Phone (585) 325-1120

360 Linden Oaks
Ste 310
Rochester, NY 14625
Phone (585) 922-5840

Interoperability endpoints

  • Direct secure messaging: timothy.oconnor@rochesterregional.org

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1053403717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 LINDEN OAKS STE 310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252814",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 LINDEN OAKS STE 310",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252814",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Hagen Dr",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252660",
            "country_code": "US",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1445 Portland Ave Ste G-01",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213008",
            "country_code": "US",
            "telephone_number": "585-922-5840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Hagen Dr",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252660",
            "country_code": "US",
            "telephone_number": "585-922-5840",
            "fax_number": "585-586-7558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLASTIC SURGERY GROUP OF ROCHESTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "585-249-1950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Timothy.OConnor@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1445 Portland Ave Ste G-01",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.