Individual provider Active NPI

Sharada Menon, MD

  • Pediatrics Physician
  • Webster, NY
National Provider Identifier
1073504353
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
213230 Issued in NY
Practice address
45 Webster Commons Blvd
Ste 200
Webster, NY 14580-3813
Phone
(585) 872-0650
Fax
(585) 872-2474
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 213230 NY Primary

Addresses

Primary practice location

45 Webster Commons Blvd
Ste 200
Webster, NY 14580-3813

Mailing address

45 Webster Commons Blvd
Ste 200
Webster, NY 14580-3813
Phone (585) 872-0650

Other identifiers 1

IdentifierTypeStateIssuer
01922590MedicaidNY

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
I20110211000305 NY Practitioner - Pediatric Medicine 1951581776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

222 Alexander St
Rochester, NY 14607-4039
Phone (585) 922-8210

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213230NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Pediatrics CurrentSince Aug 31, 2022 Accepting new patients
Webster Medical Group, PC. Pediatrics CurrentSince Aug 17, 2010 Accepting new patients
Rochester General Hospital CurrentSince Aug 31, 2022 Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

222 Alexander St
Ste 4100
Rochester, NY 14607
Phone (585) 922-8225

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

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

222 Alexander St
Rochester, NY 14607
Phone (585) 546-3280

45 Webster Commons Blvd
#200
Webster, NY 14580
Phone (585) 872-0650

Interoperability endpoints

  • Direct secure messaging: smenon10535@direct.rochesterregional.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1073504353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WEBSTER COMMONS BLVD",
            "address_2": "STE 200",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803813",
            "telephone_number": "585-872-0650",
            "fax_number": "585-872-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WEBSTER COMMONS BLVD",
            "address_2": "STE 200",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803813",
            "telephone_number": "585-872-0650",
            "fax_number": "585-872-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "SHARADA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "213230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01922590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.