Individual provider Active NPI

Rory P Houghtalen, MD

  • Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1215033949
Registry record updated Mar 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
168914 Issued in NY
Practice address
81 Lake Ave
Rochester, NY 14608-1410
Phone
(585) 368-6900
Fax
(585) 423-9523
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 168914 NY Primary

Addresses

Primary practice location

81 Lake Ave
Rochester, NY 14608-1410

Mailing address

81 Lake Ave
Rochester, NY 14608-1410
Phone (585) 368-6900

Other identifiers 1

IdentifierTypeStateIssuer
01214364MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050610000288 NY Practitioner - Psychiatry 4183668189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Vermont College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

135 Sullys TRL
Suite 11
Pittsford, NY 14534-4564
Phone (585) 381-1558

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rory P Houghtalen MD PLLC Psychiatry CurrentSince May 14, 2017 Accepting new patients

Locations

135 Sullys Trl
Ste 11
Pittsford, NY 14534
Phone (585) 381-1558

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427500800000",
    "number": "1215033949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900",
            "fax_number": "585-423-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900",
            "fax_number": "585-423-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTALEN",
        "first_name": "RORY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "168914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01214364",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.