Individual provider Active NPI

Rachel Dorrer

  • Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1396398566
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5823 Widewaters Pkwy
East Syracuse, NY 13057-3084
Phone
(315) 500-7546
NPI assigned
Jul 17, 2019
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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 NY Primary

Addresses

Primary practice location

5823 Widewaters Pkwy
East Syracuse, NY 13057-3084

Mailing address

3321 Lake Rd N
Brockport, NY 14420-9305
Phone (585) 331-6833

Other practice location 1

3321 Lake Rd N
Brockport, NY 14420-9305
Phone (585) 331-6833

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
I20200318001245 NY Practitioner - Physician Assistant 7618305004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empire Dermatology PLLCGroup PAC ID 9234417452, 14 clinicians

Practice addresses (Care Compare)

5823 Widewaters Pkwy
Suite 4
East Syracuse, NY 13057-3081
Phone (315) 500-7546

Merit-based Incentive Payment System (MIPS)

Final score
81.8 of 100Reported as group
Quality
70
Promoting interoperability
97
Improvement activities
40
Cost
71.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024654NYMDEndodontist

Interoperability endpoints

  • Direct secure messaging: rdorrer1@empirederm.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1396398566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 LAKE RD N",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144209305",
            "telephone_number": "585-331-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573084",
            "telephone_number": "315-500-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3321 Lake Rd N",
            "address_purpose": "LOCATION",
            "city": "Brockport",
            "state": "NY",
            "postal_code": "144209305",
            "country_code": "US",
            "telephone_number": "585-331-6833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORRER",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.