Individual provider Active NPI

Syed Ali Rahmatullah, M.D.

  • Family Medicine Physician
  • Webster, NY
National Provider Identifier
1205377496
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
322214 Issued in NY
Practice address
1900 Empire Blvd Ste 100
Webster, NY 14580-1934
Phone
(585) 787-0720
NPI assigned
Mar 20, 2017
Last updated
Jun 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 284119 MA
Family Medicine Physician 207Q00000X 322214 NY Primary

Addresses

Primary practice location

1900 Empire Blvd Ste 100
Webster, NY 14580-1934

Mailing address

1900 Empire Blvd Ste 100
Webster, NY 14580-1934
Phone (585) 787-0720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200928001860 MA Practitioner - Family Practice 5991124760
I20230602001621 NY Practitioner - Family Practice 5991124760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Hospital of RochesterGroup PAC ID 5496641631, 403 clinicians

Practice addresses (Care Compare)

1900 Empire Blvd
Suite 100
Webster, NY 14580-1999
Phone (585) 787-0720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
322214NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester Family Medicine CurrentSince Jul 17, 2023 Accepting new patients
Highland Hospital of Rochester CurrentSince Jul 17, 2023 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

601 Elmwood Ave
#320
Rochester, NY 14642

1900 Empire Blvd
Ste 100
Webster, NY 14580
Phone (585) 787-0720

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1205377496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 EMPIRE BLVD STE 100",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801934",
            "telephone_number": "585-787-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 EMPIRE BLVD STE 100",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801934",
            "telephone_number": "585-787-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMATULLAH",
        "first_name": "SYED",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "284119",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "322214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.