Active NPI
Mary A Dinnan, PA
- Physician Assistant
- Rochester, NY
National Provider Identifier
1194792960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000557
- Practice address
- 1338 E Ridge Rd
Suite 101
Rochester, NY 14621-2018 - Phone
- (585) 922-7140
- Fax
- (585) 336-9029
- NPI assigned
- Mar 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000557 | NY | Primary |
Addresses
Primary practice location
1338 E Ridge Rd
Suite 101
Rochester, NY 14621-2018
Mailing address
1338 E Ridge Rd
Suite 101
Rochester, NY 14621-2018
Phone (585) 922-7140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01954145 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000557 | NY | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1194792960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1338 E RIDGE RD",
"address_2": "SUITE 101",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146212018",
"telephone_number": "585-922-7140",
"fax_number": "585-336-9029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1338 E RIDGE RD",
"address_2": "SUITE 101",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146212018",
"telephone_number": "585-922-7140",
"fax_number": "585-336-9029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINNAN",
"first_name": "MARY",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "000557",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01954145",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}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 Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.