NPIMap

Organization Active NPI

University of Rochester Pediatric Otolaryngology Associates

  • Pediatric Otolaryngology Physician
  • Rochester, NY
National Provider Identifier
1295984532
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
Legal business name
UNIVERSITY OF ROCHESTER PEDIATRIC OTOLARYNGOLOGY ASSOCIATES
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 758-7671
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Jill M Hetterich
Title
Senior Director, Finance Urmfg
Phone
(585) 756-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YP0228X Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box 635
Rochester, NY 14642-0001
Phone (585) 758-5700

Other identifiers 1

IdentifierTypeStateIssuer
03085283MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000570 NY Part B Supplier - Clinic/Group Practice 7719040369 Receives reassigned benefits from 10 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

2337 S Clinton Ave
Ste 200
Rochester, NY 14618

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1295984532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 635",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-758-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-758-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ROCHESTER PEDIATRIC OTOLARYNGOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, FINANCE URMFG",
        "authorized_official_telephone_number": "585-756-4003"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03085283",
            "state": "NY"
        }
    ],
    "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 Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.