Individual provider Active NPI

Muhammad Mustafa Memon, MD

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1366129272
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
345441 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4164
Phone
(585) 723-7000
Fax
(585) 723-7871
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 345441 NY Primary
Hospitalist Physician 208M00000X 345441 NY

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4164

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-5067

Other practice location 2

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-9561

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmemon369953@direct.rochesterregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1366129272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "fax_number": "585-922-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264164",
            "telephone_number": "585-723-7000",
            "fax_number": "585-723-7871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213011",
            "country_code": "US",
            "telephone_number": "585-922-5067",
            "fax_number": "585-922-2908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Coulter Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Springs",
            "state": "NY",
            "postal_code": "144321122",
            "country_code": "US",
            "telephone_number": "315-462-9561",
            "fax_number": "315-462-2638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEMON",
        "first_name": "MUHAMMAD MUSTAFA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "345441",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "345441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmemon369953@direct.rochesterregional.org",
            "affiliation": "N",
            "endpointDescription": "Rochester Regional Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1555 Long Pond Rd",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146264164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.