Active NPI
Daniel Vyverberg, PHARMD
- Pharmacist
- Rochester, NY
National Provider Identifier
1316450430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 068494
- Practice address
- 665 Long Pond Rd
Rochester, NY 14612-3007 - Phone
- (585) 210-4701
- Fax
- (585) 210-4707
- NPI assigned
- Nov 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 068494 | NY | Primary |
| Pharmacist | 183500000X | 61353 | TX |
Addresses
Primary practice location
665 Long Pond Rd
Rochester, NY 14612-3007
Mailing address
665 Long Pond Rd
Rochester, NY 14612-3007
Phone (585) 210-4701
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068494 | NY | MD | Pharmacist |
| 61353 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
665 Long Pond Rd
Rochester, NY 14612
Phone (585) 210-4701
Organizations & group practices 3
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": "1510272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650240000000",
"number": "1316450430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "665 LONG POND RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146123007",
"telephone_number": "585-210-4701",
"fax_number": "585-210-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "665 LONG POND RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146123007",
"telephone_number": "585-210-4701",
"fax_number": "585-210-4707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VYVERBERG",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-10",
"last_updated": "2022-04-18",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "068494",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "61353",
"primary": false
}
],
"identifiers": [],
"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 Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.