Individual provider Active NPI

Nicole Vavrina, D.O.

  • Family Medicine Physician
  • Pittsford, NY
National Provider Identifier
1316203318
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
280643 Issued in NY
Practice address
167 Sullys TRL
Ste 100
Pittsford, NY 14534-4567
Phone
(585) 758-0800
Fax
(585) 381-1577
NPI assigned
Apr 4, 2012
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 280643 NY Primary

Addresses

Primary practice location

167 Sullys TRL
Ste 100
Pittsford, NY 14534-4567

Mailing address

167 Sullys TRL
Ste 100
Pittsford, NY 14534-4567
Phone (585) 758-0800

Other identifiers 1

IdentifierTypeStateIssuer
04503962MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nvavrina73151@direct.urmc.rochester.edu Direct
Direct Messaging Address nvavrina73151@direct.urmc.rochester.edu Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018001642 NY Practitioner - Family Practice 3577851948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2400 Clinton S Ave F
Rochester, NY 14618-2668
Phone (585) 244-7200

2400 Clinton S Ave G
Rochester, NY 14618-2668
Phone (585) 341-7685

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

2400 S Clinton Ave
BLDG H
Rochester, NY 14618-2668
Phone (585) 341-7200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Strong Medical Group Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
University of Rochester CurrentSince Apr 24, 2017 Accepting new patients
University of Rochester CurrentSince Apr 24, 2017 Accepting new patients
Highland Hospital of Rochester Family Medicine Past Accepting new patients

Locations

3669 Countryside Ln
Marion, NY 14505
Phone (315) 926-7733

167 Sullys Trl
Ste 100
Pittsford, NY 14534
Phone (585) 758-0800

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

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

601 Elmwood Ave
#320
Rochester, NY 14642

Interoperability endpoints

  • Direct secure messaging: nvavrina73151@direct.urmc.rochester.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1316203318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 SULLYS TRL",
            "address_2": "STE 100",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344567",
            "telephone_number": "585-758-0800",
            "fax_number": "585-381-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 SULLYS TRL",
            "address_2": "STE 100",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344567",
            "telephone_number": "585-758-0800",
            "fax_number": "585-381-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRINA",
        "first_name": "NICOLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "280643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04503962",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvavrina73151@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvavrina73151@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsford, NY

Sources for this page

Verify at the official NPI Registry.