NPIMap

Organization Active NPI

Pediatric Group Univ of Rochester

Doing business as Pediatric Palliative Care

  • Pediatric Hospice and Palliative Medicine Physician
  • Rochester, NY
National Provider Identifier
1114489176
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
Legal business name
PEDIATRIC GROUP UNIV OF ROCHESTER
Doing business as
Pediatric Palliative Care
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 784-9750
NPI assigned
Apr 1, 2019
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Jill M Hetterich
Title
Senior Director of Finance-Urmfg
Phone
(585) 756-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080H0002X Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box 635
Rochester, NY 14642-0001
Phone (585) 784-9750

Other names 1

  • Pediatric Palliative Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001273 NY Part B Supplier - Clinic/Group Practice 5496747362 Receives reassigned benefits from 96 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochester, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Reach Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1114489176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 635",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-784-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-784-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GROUP UNIV OF ROCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF FINANCE-URMFG",
        "authorized_official_telephone_number": "585-756-4003"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 1, 2019; 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.