Organization Active NPI

Robert H. Oliver, M.D., PLLC

  • Otolaryngology Physician
  • Rochester, NY
National Provider Identifier
1073658704
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
211704 Issued in NY
Legal business name
ROBERT H. OLIVER, M.D., PLLC
Practice address
1295 Portland Ave
Suite 24
Rochester, NY 14621-2731
Phone
(585) 342-2080
Fax
(585) 301-4037
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Dr. Robert Hugh Oliver, M.D.NPI 1003819368
Title
Owner
Phone
(585) 342-2080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 211704 NY Primary

Addresses

Primary practice location

1295 Portland Ave
Suite 24
Rochester, NY 14621-2731

Mailing address

1295 Portland Ave
Suite 24
Rochester, NY 14621-2731
Phone (585) 342-2080

Other identifiers 1

IdentifierTypeStateIssuer
000917639004MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070402000498 NY Part B Supplier - Clinic/Group Practice 5597869438 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1073658704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 PORTLAND AVE",
            "address_2": "SUITE 24",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212731",
            "telephone_number": "585-342-2080",
            "fax_number": "585-301-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 PORTLAND AVE",
            "address_2": "SUITE 24",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212731",
            "telephone_number": "585-342-2080",
            "fax_number": "585-301-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H. OLIVER, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HUGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-342-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "211704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000917639004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Oct 15, 2007; 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.