Individual provider Active NPI

Jeanine Petote

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1336379858
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019287 Issued in NY
Practice address
1180 Saint Paul St
Rochester, NY 14621-5251
Phone
(585) 262-8888
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 019287 NY Primary

Addresses

Primary practice location

1180 Saint Paul St
Rochester, NY 14621-5251

Mailing address

1180 Saint Paul St
Rochester, NY 14621-5251
Phone (585) 262-8888

Other practice location 1

149 N Main St
Fairport, NY 14450-1434
Phone (585) 377-2230

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

State licenses

LicenseStateTypeSpecialty
019287NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Start Pediatric Services Past Accepting new patients

Organizations & group practices 1

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1336379858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SAINT PAUL ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146215251",
            "telephone_number": "585-262-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 SAINT PAUL ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146215251",
            "telephone_number": "585-262-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 N Main St",
            "address_purpose": "LOCATION",
            "city": "Fairport",
            "state": "NY",
            "postal_code": "144501434",
            "country_code": "US",
            "telephone_number": "585-377-2230",
            "fax_number": "585-377-2312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETOTE",
        "first_name": "JEANINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019287",
            "primary": true
        }
    ],
    "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 Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.