Individual provider Active NPI

Melissa Sydor-Kauffman, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1265822472
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077614-1 Issued in NY
Practice address
300 Crittenden Blvd
Rochester, NY 14642-0001
Phone
(585) 273-2157
Fax
(585) 276-0422
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 077614-1 NY Primary

Addresses

Primary practice location

300 Crittenden Blvd
Rochester, NY 14642-0001

Mailing address

36 Winthrop St
Rochester, NY 14607-1326
Phone (585) 358-0609

Other names 1

  • Ms. Melissa Sydor Professional name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150512000253 NY Practitioner - Clinical Social Worker 4183943202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

36 Winthrop St
Rochester, NY 14607-1326
Phone (585) 358-0609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077614-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Rochester Area Community Experience LCSW PLLC Clinical Current Accepting new patients
Melissa Sydor LCSW, P. C. Clinical CurrentSince Mar 21, 2018 Accepting new patients

Locations

36 Winthrop St
Rochester, NY 14607
Phone (585) 502-1445

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1265822472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WINTHROP ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071326",
            "telephone_number": "585-358-0609",
            "fax_number": "585-625-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-273-2157",
            "fax_number": "585-276-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYDOR-KAUFFMAN",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077614-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SYDOR",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.