Individual provider Active NPI

Madeline Glynn

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1275129496
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027554 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4164
Phone
(585) 723-7281
NPI assigned
Dec 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027554 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4164

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

601 Elmwood Ave.
Rochester, NY 14642-0001
Phone (585) 275-9238

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
I20221028001920 NY Practitioner - Physician Assistant 3476920760 Reassigns benefits to 3 organizations

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
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 429-2289

1565 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7366

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

Hospital & facility affiliations

  • Unity Hospital Hospital, Rochester, NY, CCN 330226

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Oct 12, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Oct 12, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Aug 22, 2024 Accepting new patients

Locations

601 Elmwood Ave
#278984
Rochester, NY 14642
Phone (585) 275-1200

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

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: mglynn238369@direct.urmc.rochester.edu

Organizations & group practices 5

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 7

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": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1275129496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264164",
            "telephone_number": "585-723-7281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave.",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-9238",
            "fax_number": "585-276-1543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "MADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-13",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.