Individual provider Active NPI

Jeffrey Bazarian II, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Rochester, NY
National Provider Identifier
1063430239
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
176211 Issued in NY
Practice address
4901 Lac de Ville Blvd
Suite 250
Rochester, NY 14618-5647
Phone
(585) 275-3271
Fax
(585) 442-2949
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 176211 NY
Internal Medicine Physician 207R00000X 176211 NY
Physical Medicine & Rehabilitation Physician 208100000X 176211 NY Primary

Addresses

Primary practice location

4901 Lac de Ville Blvd
Suite 250
Rochester, NY 14618-5647

Mailing address

601 Elmwood Ave
Box 655C
Rochester, NY 14642-0001
Phone (585) 341-3015

Other identifiers 1

IdentifierTypeStateIssuer
01720850MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbazarian3454@direct.urmc.rochester.edu Direct
Direct Messaging Address jbazarian3454@direct.urmc.rochester.edu Direct

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
I20051017000053 NY Practitioner - Internal Medicine 5698791077 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176211NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Apr 4, 2015 Accepting new patients
University of Rochester Internal Medicine Current Accepting new patients
U of R Neurology Department CurrentSince Aug 5, 2018 Accepting new patients
University of Rochester Internal Medicine CurrentSince Apr 4, 2015 Accepting new patients

Locations

1445 Portland Ave
Ste 305
Rochester, NY 14621
Phone (585) 275-8344

601 Elmwood Ave
#655
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#655C
Rochester, NY 14642

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

4901 Lac de Ville Blvd
Ste 250
Rochester, NY 14618
Phone (585) 275-3271

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1063430239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 655C",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-341-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 LAC DE VILLE BLVD",
            "address_2": "SUITE 250",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185647",
            "telephone_number": "585-275-3271",
            "fax_number": "585-442-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZARIAN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "176211",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "176211",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "176211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01720850",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbazarian3454@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbazarian3454@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.