Individual provider Active NPI

Elizabeth Tellier, RPA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1366477218
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010976 Issued in NY
Practice address
1455 E Ridge Rd
Rochester, NY 14621
Phone
(585) 922-4882
Fax
(585) 922-4936
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010976 NY Primary

Addresses

Primary practice location

1455 E Ridge Rd
Rochester, NY 14621

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-0553

Other practice location 1

77 Sullys Trl
Pittsford, NY 14534-3754
Phone (585) 248-5300

Other practice location 2

77 Sullys Trl
Pittsford, NY 14534-3754
Phone (585) 248-5300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000302 NY Practitioner - Physician Assistant 2567427610 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
010976NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince May 1, 2015 Accepting new patients
Western New York Medical Practice P.C. CurrentSince May 10, 2019 Accepting new patients
University of Rochester CurrentSince May 1, 2015 Accepting new patients
Western New York Medical Practice PC CurrentSince May 10, 2019 Accepting new patients
Rochester General Hospital CurrentSince May 10, 2019 Accepting new patients

Locations

77 Sullys Trl
Pittsford, NY 14534
Phone (585) 248-5300

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

400 Red Creek Dr
Ste 110
Rochester, NY 14623
Phone (585) 486-0147

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

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1455 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-4103

Interoperability endpoints

  • Direct secure messaging: elizabeth.tellier.1@29290.direct.athenahealth.com

Organizations & group practices 8

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1366477218",
    "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",
            "telephone_number": "585-922-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4882",
            "fax_number": "585-922-4936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Sullys Trl",
            "address_purpose": "LOCATION",
            "city": "Pittsford",
            "state": "NY",
            "postal_code": "145343754",
            "country_code": "US",
            "telephone_number": "585-248-5300",
            "fax_number": "585-248-3427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Sullys Trl",
            "address_purpose": "LOCATION",
            "city": "Pittsford",
            "state": "NY",
            "postal_code": "145343754",
            "country_code": "US",
            "telephone_number": "585-248-5300",
            "fax_number": "585-248-3427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLIER",
        "first_name": "ELIZABETH",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.