NPIMap

Organization Active NPI

Independent Living for Seniors - Fee for Service

  • Health Maintenance Organization
  • Rochester, NY
National Provider Identifier
1093935967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
INDEPENDENT LIVING FOR SENIORS - FEE FOR SERVICE
Practice address
2066 Hudson Ave
Rochester, NY 14617-4300
Phone
(585) 922-2800
NPI assigned
Apr 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John P Midolo
Title
VP-Patient Financial Services
Phone
(585) 922-1958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X NU Primary

Addresses

Primary practice location

2066 Hudson Ave
Rochester, NY 14617-4300

Mailing address

2066 Hudson Ave
Rochester, NY 14617-4300
Phone (585) 922-2800

Other identifiers 1

IdentifierTypeStateIssuer
00303315MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Richard Stolarczyk31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093935967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174300",
            "telephone_number": "585-922-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 HUDSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174300",
            "telephone_number": "585-922-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIVING FOR SENIORS - FEE FOR SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDOLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VP-PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "585-922-1958",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00303315",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.