NPIMap

Organization Active NPI

His Branches, Inc.

  • Community Health Clinic/Center
  • Rochester, NY
National Provider Identifier
1134485840
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
2701240R Issued in NY
Legal business name
HIS BRANCHES, INC.
Practice address
340 Arnett Blvd
Rochester, NY 14619-1147
Phone
(585) 235-9000
Fax
(585) 235-4131
NPI assigned
Apr 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Valerie Scuorzo
Title
Practice Manager
Phone
(585) 235-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 2701240R NY Primary

Addresses

Primary practice location

340 Arnett Blvd
Rochester, NY 14619-1147

Mailing address

340 Arnett Blvd
Rochester, NY 14619-1147
Phone (585) 235-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20130328000574 NY Part B Supplier - Clinic/Group Practice 2163667833 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Rochester, NY
O20180523000903 NY Part A Provider - Federally Qualified Health Center (FQHC) 2163667833 Practice locations: Rochester, NY
O20180820000353 NY Part A Provider - Federally Qualified Health Center (FQHC) 2163667833 Practice locations: Rochester, NY

Federally qualified health center certification: CCN 571113

Legal name
HIS BRANCHES INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 16, 2018
Last certification
Jun 16, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 20, 1980 in NY
Enrollment address
918 N Goodman St
Rochester, NY 14609-4652

Federally qualified health center certification: CCN 571124

Legal name
HIS BRANCHES INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 1, 2018
Last certification
Apr 1, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 20, 1980 in NY
Enrollment address
340 Arnett Blvd
Rochester, NY 14619-1147

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

340 Arnett Blvd
Rochester, NY 14619
Phone (585) 235-2250

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jonathon Walters Individual Corporate DirectorVice President Jan 1, 2021 11.11%
Corporate Director Jan 1, 2021 11.11%
David C Spencer Individual Corporate DirectorBoard Member Apr 1, 2018 11.11%
Michael Beinetti Individual Corporate DirectorBoard Member Jan 1, 2023 11.11%
Corporate Director Jan 1, 2023 11.11%
Elizabeth Larter Individual Corporate Director Jan 1, 2023 11.11%
Joshua Moody Individual Corporate DirectorDirector of Finance Aug 1, 2019
W-2 Managing EmployeeDirector of Finance Aug 1, 2019
W-2 Managing Employee Aug 1, 2019
Emily Waller Individual Corporate DirectorSecretary Jan 1, 2023 11.11%
Corporate Director Jan 1, 2023 11.11%
Nancy M Green Individual Corporate DirectorPresident Jun 1, 2019 11.11%
Corporate Director Jun 1, 2019 11.11%
Augustin Rodriguez Individual Corporate Director Oct 1, 2020 11.11%
Renita Graves Individual Corporate DirectorBoard Member Dec 1, 2019 11.11%
Corporate Director Dec 1, 2019 11.11%
Javier Chona Individual Corporate DirectorBoard Member Jan 1, 2023 11.11%
Corporate Director Jan 1, 2023 11.11%
Valerie Scuorzo Individual W-2 Managing EmployeeFinancial Project Manager Jun 1, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1134485840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 ARNETT BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146191147",
            "telephone_number": "585-235-9000",
            "fax_number": "585-235-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 ARNETT BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146191147",
            "telephone_number": "585-235-9000",
            "fax_number": "585-235-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS BRANCHES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "SCUORZO",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "585-235-9000"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NY",
            "license": "2701240R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.