Active NPI
Lynda J. Dimitroff, PHD, MSED, BSN, RN
- Mental Health Counselor
- Rochester, NY
National Provider Identifier
1255830394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 490 E Ridge Rd
Rochester, NY 14621-1229 - Phone
- (585) 922-2735
- Fax
- (585) 922-2646
- NPI assigned
- Feb 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
490 E Ridge Rd
Rochester, NY 14621-1229
Mailing address
490 E Ridge Rd
Rochester, NY 14621-1229
Phone (585) 922-2735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010844 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1255830394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 E RIDGE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146211229",
"telephone_number": "585-922-2735",
"fax_number": "585-922-2646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 E RIDGE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146211229",
"telephone_number": "585-922-2735",
"fax_number": "585-922-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMITROFF",
"first_name": "LYNDA J.",
"name_prefix": "Dr.",
"credential": "PHD, MSED, BSN, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-05",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.