NPIMap

Organization Active NPI

Rochester General Hospital

Doing business as Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1356412712
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROCHESTER GENERAL HOSPITAL
Doing business as
Rochester General Medical Groups
Practice address
2350 Ridgeway Ave
Rochester, NY 14626-4112
Phone
(585) 922-3150
Fax
(585) 922-3175
NPI assigned
Nov 10, 2006
Last updated
Jun 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Authorized official

Name
Paula Tinch
Title
SVP-Finance
Phone
(585) 922-1223

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X
Dermatology Physician 207N00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Pediatrics Physician 208000000X
Physical Medicine & Rehabilitation Physician 208100000X
Psychiatry Physician 2084P0800X
Vascular Surgery Physician 2086S0129X

Addresses

Primary practice location

2350 Ridgeway Ave
Rochester, NY 14626-4112

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3150

Other identifiers 2

IdentifierTypeStateIssuer
00303315MedicaidNY
RR10055OtherNYRR MEDICARE SUBMITTER ID

Other names 1

  • Rochester General Medical Groups Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031121000644 NY Part B Supplier - Clinic/Group Practice 0244149474 Receives reassigned benefits from 2,800 practitioners
7 other NPIs on this enrollment
O20061017000162 NY Part A Provider - Hospital 0244149474 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20260319003957 PR Part B Supplier - Clinic/Group Practice 8224036835 Receives reassigned benefits from 1 practitioner
Practice locations: Carolina, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356412712. Details of each certification follow.

Hospital certification: CCN 330125001

Legal name
ROCHESTER GENERAL HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
1425 Portland Ave
Rochester, NY 14621-3001
Opt Extension Site
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 30)

229 Summit St
Batavia, NY 14020
Phone (585) 343-4555

7575 State Route 54
Bath, NY 14810
Phone (607) 776-7357

2 Coulter Rd
Ste 2615
Clifton Springs, NY 14432
Phone (315) 462-1472

4772 N French Rd
East Amherst, NY 14051
Phone (716) 404-2604

1200 Driving Park Ave
Ste 5
Newark, NY 14513
Phone (585) 922-0400

1212 Driving Park Ave
Newark, NY 14513

2067 Fairport Nine Mile Point Rd
Penfield, NY 14526
Phone (585) 377-5420

10 Hagen Dr
Ste 10
Rochester, NY 14625
Phone (585) 241-6650

1299 Portland Ave
Ste 17
Rochester, NY 14621
Phone (585) 922-4003

1415 Portland Ave
Ste 190
Rochester, NY 14621
Phone (585) 336-5000

1415 Portland Ave
Ste 300
Rochester, NY 14621

1425 Portland Ave
Ste 200
Rochester, NY 14621

1425 Portland Ave
Ste 340
Rochester, NY 14621

1425 Portland Ave
Ste 400
Rochester, NY 14621
Phone (585) 922-4200

1425 Portland Ave
Ste 4500
Rochester, NY 14621

1815 S Clinton Ave
Ste 310
Rochester, NY 14618
Phone (585) 473-3535

20 Hagen Dr
Ste 300
Rochester, NY 14625
Phone (585) 586-7550

222 Alexander St
Ste 1100
Rochester, NY 14607
Phone (585) 922-8585

222 Alexander St
Ste 41004200
Rochester, NY 14607
Phone (585) 922-8230

222 Alexander St
Ste 5000
Rochester, NY 14607
Phone (585) 922-8003

2350 Ridgeway Ave
Ste B
Rochester, NY 14626
Phone (585) 225-0950

2420 Ridgeway Ave
Rochester, NY 14626
Phone (585) 227-4000

254 Alexander St
Rochester, NY 14607
Phone (585) 461-1991

2745 W Ridge Rd
Rochester, NY 14626
Phone (585) 225-5252

30 Hagen Dr
Rochester, NY 14625
Phone (585) 242-9450

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julia C Tedesco Individual Corporate DirectorBoard Secretary Jul 1, 2019
Marcy Cardona Mulconry Individual Corporate DirectorBoard Member Jul 1, 2019
Marcie Salerno Individual W-2 Managing Employee Jan 1, 2021
Karen M Gallina Individual Corporate DirectorBoard Member Jul 1, 2014
Nichole S Holder Individual W-2 Managing EmployeeDirector Payor Enrollment Jul 1, 2020
Richard O Davis Individual Corporate OfficerCeo Mar 1, 2022
Howard Glastonbury Individual Corporate OfficerVice President CFP Corp. Finance May 1, 2020
W-2 Managing EmployeeVP CFP Corporate Finance May 1, 2020
Amanda Wilson Individual W-2 Managing Employee Jan 1, 2024
Leon T Sawyko Individual Corporate DirectorBoard Member Jul 1, 2014
Joseph Miles Individual W-2 Managing Employee Oct 22, 2001
Thomas P Riley Individual Corporate DirectorBoard Member Jul 1, 2014
Michael Cicero Individual Corporate Director Aug 1, 2021
Linda S Becker Individual Corporate DirectorBoard Member Jun 1, 2009
Jeffrey C. Mapstone Individual Corporate DirectorBoard Member Jul 1, 2014
Walter Larkin Individual Corporate Director Aug 1, 2021
Thomas R Crilly Individual Corporate OfficerExecutive Vice President, Cfo Apr 1, 2015
W-2 Managing EmployeeExecutive Vice President, Cfo Apr 1, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2,901

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 2,901

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1356412712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-3150",
            "fax_number": "585-922-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 RIDGEWAY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264112",
            "telephone_number": "585-922-3150",
            "fax_number": "585-922-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "TINCH",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "SVP-FINANCE",
        "authorized_official_telephone_number": "585-922-1223"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00303315",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE SUBMITTER ID",
            "identifier": "RR10055",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochester General Medical Groups",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.