Earlene C. Siebold M.D.P.C,

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

156287 Issued in NY

Legal business name

EARLENE C. SIEBOLD M.D.P.C,

Practice address

880 Westfall Rd
Suite a
Rochester, NY 14618-2611

Phone

(585) 244-5630

Fax

(585) 487-8250

NPI assigned

Jul 21, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Earlene C Siebold, MDNPI 1134101157

Title

Physician

Phone

(585) 244-5630

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

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

• Earlene Catherine Siebold, MD

  • Ophthalmology Physician
  • Rochester, NY
  • NPI 1134101157
  Medicare reassignment Care Compare group NPD Authorized official
• Sarah B Klein, OD

  • Optometrist
  • Rochester, NY
  • NPI 1710934252
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1215312160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 WESTFALL RD STE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182611",
            "telephone_number": "585-244-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 WESTFALL RD",
            "address_2": "SUITE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182611",
            "telephone_number": "585-244-5630",
            "fax_number": "585-487-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLENE C. SIEBOLD M.D.P.C,",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "SIEBOLD",
        "authorized_official_first_name": "EARLENE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "585-244-5630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "156287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "1045398",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01093163",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BB8505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Ead, LPN
• Diane Marie Eade, N.P.
• John M Eadie, PHARMD
• Richard F. Eagleton, PHARMACIST
• Jacqueline I Eakin, LCSW
• Deborah F. Earley, LPN
• Elisha Earley
• Mary Beth Earley, NP
• Sharon Earley, RN
• Kristine H Early, RPA-C

• Ophthalmology Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.