Individual provider Active NPI

Anthony J Dasilva, M.D.

  • Internal Medicine Physician
  • Newark, NY
National Provider Identifier
1164433900
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
179687 Issued in NY
Practice address
1208 Driving Park Ave
Newark, NY 14513-1057
Phone
(315) 359-2640
Fax
(315) 359-2645
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 179687 NY Primary

Addresses

Primary practice location

1208 Driving Park Ave
Newark, NY 14513-1057

Mailing address

1208 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 359-2640

Other identifiers 1

IdentifierTypeStateIssuer
01217385MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anthony.dasilva@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100104000118 NY Practitioner - Internal Medicine 0749321453 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
179687NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Internal Medicine Current Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Nov 1, 2016 Accepting new patients
Western New York Medical Practice P.C. Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 1983 Accepting new patients
Newark Wayne Community Hospital CurrentSince Oct 27, 2019 Accepting new patients
Newark Wayne Community Hospital CurrentSince Oct 27, 2019 Accepting new patients
Rochester General Hospital Internal Medicine CurrentSince Oct 1, 1983 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1208 Driving Park Ave
Newark, NY 14513
Phone (315) 359-2640

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

6692 Middle Rd
Sodus Center, NY 14551
Phone (315) 483-3205

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1164433900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131057",
            "telephone_number": "315-359-2640",
            "fax_number": "315-359-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131057",
            "telephone_number": "315-359-2640",
            "fax_number": "315-359-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASILVA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "179687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01217385",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anthony.dasilva@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1208 Driving Park Ave",
            "city": "Newark",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145131057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

Verify at the official NPI Registry.