NPIMap

Organization Active NPI

Internal Medicine Group

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Rochester, NY
National Provider Identifier
1184255176
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
Legal business name
INTERNAL MEDICINE GROUP
Practice address
46 Prince St Ste 3001
Rochester, NY 14607-1023
Phone
(585) 602-0720
NPI assigned
Jan 29, 2020
Last updated
Jan 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
URMCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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
Phone
(585) 756-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X NU Primary

Addresses

Primary practice location

46 Prince St Ste 3001
Rochester, NY 14607-1023

Mailing address

46 Prince St Ste 3001
Rochester, NY 14607-1023
Phone (585) 530-2050

Other names 1

  • URMC Healthy Living Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040120000491 NY Part B Supplier - Clinic/Group Practice 3476454661 Receives reassigned benefits from 375 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochester, NY
O20230509002737 NY MDPP Supplier - in-Person MDPP Supplier 3476454661 Practice locations: Rochester, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Part of
University of Rochester Strong Memorial Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

46 Prince St
Rochester, NY 14607
Phone (585) 313-7748

46 Prince St
Ste 3001
Rochester, NY 14607
Phone (585) 530-2050

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 306

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 306

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1184255176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST STE 3001",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071023",
            "telephone_number": "585-530-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST STE 3001",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071023",
            "telephone_number": "585-602-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "URMC",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-05",
        "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",
        "authorized_official_telephone_number": "585-756-4003"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "URMC Healthy Living Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 12, 2021; 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.