Organization Active NPI

Stonegate Oral Surgery, LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NY
National Provider Identifier
1194987008
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
033748-1 Issued in NY
Legal business name
STONEGATE ORAL SURGERY, LLP
Practice address
2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323
Phone
(585) 254-5360
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Dr. Alan S Cassara, DMDNPI 1518172063
Title
Partner
Phone
(585) 254-5360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 033748-1 NY Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 035902 NY

Addresses

Primary practice location

2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323

Mailing address

2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323
Phone (585) 254-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100916000624 NY Part B Supplier - Clinic/Group Practice 1658496419 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

2005 Lyell Ave
Ste 210
Rochester, NY 14606
Phone (585) 254-5360

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1194987008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "address_2": "SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-254-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "address_2": "SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-254-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEGATE ORAL SURGERY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "CASSARA",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "585-254-5360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "033748-1",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "035902",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 May 19, 2015; 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.