Individual provider Active NPI

Marissa Dombovy-Johnson, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Rochester, NY
National Provider Identifier
1225488596
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
310253 Issued in NY
Practice address
2655 Ridgeway Ave Ste 420
Rochester, NY 14626-4296
Phone
(585) 723-7972
Fax
(585) 368-3119
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 310253 NY Primary

Addresses

Primary practice location

2655 Ridgeway Ave Ste 420
Rochester, NY 14626-4296

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 723-7972

Other practice location 1

2655 Ridgeway Ave Ste 440
Rochester, NY 14626-4296
Phone (585) 723-7705

Other practice location 2

1425 Portland Ave Ste 445
Rochester, NY 14621-3011
Phone (585) 922-4111

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
I20210914002150 NY Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 7911293329 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 2016
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)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

4302 Gateway Dr
Geneseo, NY 14454-9449
Phone (585) 922-1000

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Memorial Medical Center Pain Medicine CurrentSince Sep 6, 2021 Accepting new patients
United Memorial Medical Center Current Accepting new patients
Rochester General Hospital CurrentSince Sep 6, 2021 Accepting new patients
The Unity Hospital of Rochester CurrentSince Sep 6, 2021 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital Physical Medicine & Rehabilitation CurrentSince Sep 6, 2021 Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Sep 6, 2021 Accepting new patients
Rochester General Hospital Physical Medicine & Rehabilitation Current Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

4302 Gateway Dr
Geneseo, NY 14454
Phone (585) 295-5450

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

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

2655 Ridgeway Ave
Ste 420
Rochester, NY 14626
Phone (585) 723-7705

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

2655 Ridgeway Ave
Ste 440
Rochester, NY 14626
Phone (585) 723-7705

1425 Portland Ave
Ste 445
Rochester, NY 14621
Phone (585) 922-4111

Interoperability endpoints

  • Direct secure messaging: mdombovyjohnson328184@direct.rochesterregional.org

Organizations & group practices 9

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1225488596",
    "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",
            "telephone_number": "585-723-7972",
            "fax_number": "585-368-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE STE 420",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-723-7972",
            "fax_number": "585-368-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2655 Ridgeway Ave Ste 440",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264296",
            "country_code": "US",
            "telephone_number": "585-723-7705",
            "fax_number": "585-723-7788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Portland Ave Ste 445",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213011",
            "country_code": "US",
            "telephone_number": "585-922-4111",
            "fax_number": "585-922-5941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMBOVY-JOHNSON",
        "first_name": "MARISSA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "310253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.