NPIMap

Individual provider Active NPI

Theresa E Rose, PA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1194792689
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003727 Issued in NY
Practice address
2350 Ridgeway Ave
Suite a
Rochester, NY 14626-4112
Phone
(585) 225-0410
Fax
(585) 225-1921
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003727 NY Primary

Addresses

Primary practice location

2350 Ridgeway Ave
Suite a
Rochester, NY 14626-4112

Mailing address

2350 Ridgeway Ave
Suite a
Rochester, NY 14626-4112
Phone (585) 225-0410

Other identifiers 1

IdentifierTypeStateIssuer
02625845MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324001224 NY Practitioner - Physician Assistant 3678609005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Hahneman Medical College of the Pacific, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

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

2350 Ridgeway Ave
Rochester, NY 14626-4127

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
003727NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Mar 24, 2003 Accepting new patients
Rochester General Hospital CurrentSince Mar 24, 2003 Accepting new patients

Locations

77 Sullys Trl
Ste 100
Pittsford, NY 14534
Phone (585) 424-6210

1425 Portland Ave
Bldg 1
Rochester, NY 14621
Phone (585) 338-1400

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

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

2350 Ridgeway Ave
Ste A
Rochester, NY 14626
Phone (585) 225-0410

Interoperability endpoints

  • Direct secure messaging: trose33936@direct.rochesterregional.org

Organizations & group practices 3

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 7

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1194792689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 RIDGEWAY AVE",
            "address_2": "SUITE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264112",
            "telephone_number": "585-225-0410",
            "fax_number": "585-225-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 RIDGEWAY AVE",
            "address_2": "SUITE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264112",
            "telephone_number": "585-225-0410",
            "fax_number": "585-225-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "THERESA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "003727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02625845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.