Individual provider Active NPI

Ashlyn Michelle Jimenez

  • Pediatrics Physician
  • Rochester, NY
National Provider Identifier
1396321337
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
332487 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3011
Phone
(585) 922-2000
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 332487 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3011

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250905003473 NY Practitioner - Pediatric Medicine 5193109858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Kings Hwy S
Rochester, NY 14617-5504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Pediatrics Current Accepting new patients
Rochester General Hospital Pediatrics CurrentSince Jun 27, 2025 Accepting new patients
Rochester General Hospital CurrentSince Jun 27, 2025 Accepting new patients
Pediatric and Adolescent Urgent Care of Western New York Past Accepting new patients
University of California Irvine PastSince Mar 1, 2021 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: ajimenez@pedsurgentcare.medentdirect.com

Organizations & group practices 5

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": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1396321337",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213011",
            "telephone_number": "585-922-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684553",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ASHLYN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "332487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.