Organization Active NPI

Pittsford Medical, PC

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1104946714
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
192889 Issued in NY
Legal business name
PITTSFORD MEDICAL, PC
Practice address
3300 Monroe Ave
Suite 202
Rochester, NY 14618-4624
Phone
(585) 586-5140
Fax
(585) 586-7010
NPI assigned
Mar 29, 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
Dr. Tracey Quail Davidoff, MDNPI 1164510251
Title
Owner
Phone
(585) 586-5140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 192889 NY Primary

Addresses

Primary practice location

3300 Monroe Ave
Suite 202
Rochester, NY 14618-4624

Mailing address

3300 Monroe Ave
Suite 202
Rochester, NY 14618-4624
Phone (585) 586-5140

National Provider Directory

National Provider Directory

Locations

3300 Monroe Ave
Ste 201
Rochester, NY 14618
Phone (585) 507-5933

3300 Monroe Ave
Ste 202
Rochester, NY 14618
Phone (585) 586-5140

Practitioners & affiliated clinicians

Practitioners 3

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104946714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MONROE AVE",
            "address_2": "SUITE 202",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184624",
            "telephone_number": "585-586-5140",
            "fax_number": "585-586-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MONROE AVE",
            "address_2": "SUITE 202",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146184624",
            "telephone_number": "585-586-5140",
            "fax_number": "585-586-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSFORD MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIDOFF",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "QUAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-586-5140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "192889",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.