Individual provider Active NPI

Beniam R Ghebrezgabiher

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1235805565
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 South Ave
Rochester, NY 14620-2733
Phone
(585) 473-2200
NPI assigned
Aug 17, 2021
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary
Nurse Practitioner 363L00000X 27377 NY

Addresses

Primary practice location

1000 South Ave
Rochester, NY 14620-2733

Mailing address

1000 South Ave
Rochester, NY 14620-2733
Phone (585) 473-2200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bghebrezgabiher111216@direct.urmc.rochester.edu Direct
Direct Messaging Address bghebrezgabiher111216@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020000794 NY Practitioner - Physician Assistant 8527456706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 S Ave
Rochester, NY 14620-2733
Phone (585) 275-5321

601 Elmwood Ave
Rochester, NY 14642-0001

601 Elmwood Ave Box
Rochester, NY 14642-0001
Phone (585) 275-5321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
27377NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Associates of Rochester CurrentSince Oct 16, 2021 Accepting new patients
University Orthopaedic Associates of Rochester CurrentSince Oct 16, 2021 Accepting new patients

Locations

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

1000 South Ave
#78
Rochester, NY 14620

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

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

Interoperability endpoints

  • Direct secure messaging: bghebrezgabiher111216@direct.urmc.rochester.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1235805565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-473-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-473-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBREZGABIHER",
        "first_name": "BENIAM",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-07-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "27377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bghebrezgabiher111216@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": "bghebrezgabiher111216@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": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.