NPIMap

Organization Active NPI

Park Ridge Nursing Home

  • Adult Day Care Clinic/Center
  • Rochester, NY
National Provider Identifier
1255489183
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
PARK RIDGE NURSING HOME
Practice address
2300 Buffalo Rd
Building 600B
Rochester, NY 14624-1360
Phone
(585) 368-6470
Fax
(585) 368-6471
NPI assigned
Jan 8, 2007
Organization subpart
Yes
Parent organization
PARK RIDGE LIVING CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Jill Graziano
Title
VP Elderone
Phone
(585) 922-2808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

2300 Buffalo Rd
Building 600B
Rochester, NY 14624-1360

Mailing address

2300 Buffalo Rd
Building 600B
Rochester, NY 14624-1360
Phone (585) 368-6470

Other identifiers 1

IdentifierTypeStateIssuer
01186429MedicaidNY

Other names 1

  • PRNH non-occupant ADC MSAC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Park Ridge Nursing Home Inc8 organizations share this tax ID, including this one
Part of
Park Ridge Nursing Home Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2300 Buffalo Rd
Bldg 600B
Rochester, NY 14624
Phone (585) 368-6470

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1255489183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO RD",
            "address_2": "BUILDING 600B",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241360",
            "telephone_number": "585-368-6470",
            "fax_number": "585-368-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO RD",
            "address_2": "BUILDING 600B",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241360",
            "telephone_number": "585-368-6470",
            "fax_number": "585-368-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE NURSING HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK RIDGE LIVING CENTER",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "GRAZIANO",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "VP ELDERONE",
        "authorized_official_telephone_number": "585-922-2808"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01186429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRNH non-occupant ADC MSAC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRNH non-occupant ADC MSAC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.