Individual provider Active NPI

Amy McLean-Ewanow, PA

  • Surgical Physician Assistant
  • Rochester, NY
National Provider Identifier
1184656795
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
012334 Issued in NY
Practice address
1425 Portland Ave
Box 113
Rochester, NY 14621-3001
Phone
(585) 922-4840
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012334 NY Primary
Medical Physician Assistant 363AM0700X MA052360 PA

Addresses

Primary practice location

1425 Portland Ave
Box 113
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Box 113
Rochester, NY 14621-3001
Phone (585) 922-4840

Other identifiers 1

IdentifierTypeStateIssuer
02992881MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amy.mclean-ewanow@rochesterregional.org
Direct Messaging Address amy.mclean-ewanow@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000720 NY Practitioner - Physician Assistant 9638184062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA052360PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jun 10, 2012 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Jul 15, 2025 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jul 15, 2025 Accepting new patients

Locations

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

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

1425 Portland Ave
#113
Rochester, NY 14621
Phone (585) 922-4840

1415 Portland Ave
Ste 245
Rochester, NY 14621
Phone (585) 922-4715

Interoperability endpoints

  • Direct secure messaging: amcleanewanow24952@direct.rochesterregional.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1184656795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "address_2": "BOX 113",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "address_2": "BOX 113",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN-EWANOW",
        "first_name": "AMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012334",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02992881",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.mclean-ewanow@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave",
            "address_2": "Box 113",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.mclean-ewanow@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave",
            "address_2": "Box 113",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.