Individual provider Active NPI

Elizabeth Dollinger, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1376174607
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402895 Issued in NY
Practice address
103 White Spruce Blvd
Rochester, NY 14623-1610
Phone
(852) 292-5830
Fax
(585) 292-5847
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402895 NY Primary

Addresses

Primary practice location

103 White Spruce Blvd
Rochester, NY 14623-1610

Mailing address

103 White Spruce Blvd
Rochester, NY 14623-1610
Phone (585) 292-5830

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
I20200320002214 NY Practitioner - Nurse Practitioner 8527496751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
402895NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1376174607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231610",
            "telephone_number": "585-292-5830",
            "fax_number": "585-292-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231610",
            "telephone_number": "852-292-5830",
            "fax_number": "585-292-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLINGER",
        "first_name": "ELIZABETH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.