Blossom Road Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BLOSSOM ROAD MEDICINE, PLLC

Practice address

780 Blossom Rd
Rochester, NY 14610-1914

Phone

(585) 482-1141

Fax

(585) 270-4153

NPI assigned

Oct 27, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Sandra Boehlert, MDNPI 1457343972

Title

Physician

Phone

(585) 482-1141

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Boehlert, MD

  • Internal Medicine Physician
  • Albion, NY
  • NPI 1457343972
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1376948893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 BLOSSOM RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101914",
            "telephone_number": "585-482-1141",
            "fax_number": "585-270-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 BLOSSOM RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101914",
            "telephone_number": "585-482-1141",
            "fax_number": "585-270-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM ROAD MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "BOEHLERT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "585-482-1141",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1457343972",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Ann Bloom, RN
• Molly Bloomenthal
• Blossom Health Care Center, Inc.
• Blossom North
• Blossom North, LLC
• Blossom South, LLC
• Linda Blossom, P.T.
• Yveline Blot, MD
• Brittany Rose Blount, PA
• John L Blount, PTA

• Internal Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.