Active NPI
Mary J Rodman, PA
- Physician Assistant
- Pittsford, NY
National Provider Identifier
1285692087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0002661
- Practice address
- 77 Sullys Trail
Pittsford, NY 14534 - Phone
- (585) 248-5300
- Fax
- (585) 248-3427
- NPI assigned
- May 2, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0002661 | NY | Primary |
Addresses
Primary practice location
77 Sullys Trail
Pittsford, NY 14534
Mailing address
800 Carter Street
Attn Kelly Steele
Rochester, NY 14621
Phone (585) 339-4793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00355266 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 266 | NY | MD | Speech-Language Pathologist |
| 0002661 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285692087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 CARTER STREET",
"address_2": "ATTN KELLY STEELE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14621",
"telephone_number": "585-339-4793",
"fax_number": "585-336-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 SULLYS TRAIL",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "14534",
"telephone_number": "585-248-5300",
"fax_number": "585-248-3427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODMAN",
"first_name": "MARY",
"middle_name": "J",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "0002661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00355266",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.