Individual provider Active NPI

Diego Olvera

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1215516968
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
333278 Issued in NY
Practice address
293 Upper Falls Blvd
Rochester, NY 14605-2184
Phone
(585) 922-0200
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 333278 NY Primary

Addresses

Primary practice location

293 Upper Falls Blvd
Rochester, NY 14605-2184

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

5755 Almeda Rd Unit 127
Houston, TX 77004-7646
Phone (210) 391-8540

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dolvera402729@direct.rochesterregional.org Direct

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
I20241204004161 NY Practitioner - Family Practice 2264968973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

293 Upper Falls Blvd
Rochester, NY 14605-2184
Phone (585) 922-0200

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Rochester General Hospital CurrentSince Oct 21, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

293 Upper Falls Blvd
Rochester, NY 14605
Phone (585) 922-0200

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Interoperability endpoints

  • Direct secure messaging: dolvera402729@direct.rochesterregional.org

Organizations & group practices 4

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1215516968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 UPPER FALLS BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052184",
            "telephone_number": "585-922-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5755 Almeda Rd Unit 127",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770047646",
            "country_code": "US",
            "telephone_number": "210-391-8540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLVERA",
        "first_name": "DIEGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "333278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dolvera402729@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "293 Upper Falls Blvd",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146052184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.