Individual provider Active NPI

Rebecca Tyson Lavender, MD

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1235456955
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
266403 Issued in NY
Practice address
454 E Broad St
Suite 100
Rochester, NY 14607-1724
Phone
(585) 276-7640
Fax
(585) 325-4255
NPI assigned
Apr 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 266403 NY Primary

Addresses

Primary practice location

454 E Broad St
Suite 100
Rochester, NY 14607-1724

Mailing address

601 Elmwood Ave
Box 278980
Rochester, NY 14642-0001
Phone (585) 276-7640

Other names 1

  • Rebecca Tyson Cornelison Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rlavender11881@direct.urmc.rochester.edu Direct
Direct Messaging Address rlavender11881@direct.urmc.rochester.edu 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
I20141023000738 NY Practitioner - Family Practice 5193946747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Rochester School of Medicine and Dentistry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

10 S Pointe LNDG
Rochester, NY 14606-3481
Phone (585) 426-4084

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Oct 6, 2014 Accepting new patients
University of Rochester CurrentSince Jul 22, 2015 Accepting new patients
University of Rochester CurrentSince Jul 22, 2015 Accepting new patients
Highland Hospital of Rochester CurrentSince Oct 6, 2014 Accepting new patients

Locations

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

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

454 E Broad St
#100
Rochester, NY 14607
Phone (585) 276-7640

601 Elmwood Ave
#278980
Rochester, NY 14642
Phone (585) 768-2620

10 S Pointe Lndg
Rochester, NY 14606
Phone (585) 244-0332

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: rlavender11881@direct.urmc.rochester.edu

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.

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1235456955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 278980",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-7640",
            "fax_number": "585-325-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 E BROAD ST",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071724",
            "telephone_number": "585-276-7640",
            "fax_number": "585-325-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "REBECCA",
        "middle_name": "TYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "266403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlavender11881@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlavender11881@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "CORNELISON",
            "middle_name": "TYSON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.