NPIMap

Organization Active NPI

Helendale Dermatology & Medical Spa, PLLC

  • Dermatology Physician
  • Rochester, NY
National Provider Identifier
1396913489
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
199172 Issued in NY
Legal business name
HELENDALE DERMATOLOGY & MEDICAL SPA, PLLC
Practice address
500 Helendale Rd Ste 100
Rochester, NY 14609-3109
Phone
(585) 266-5420
Fax
(585) 266-5423
NPI assigned
Feb 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Dr. Elizabeth Ann Arthur, M.D.NPI 1346219953
Title
Owner
Phone
(585) 266-5420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 199172 NY Primary

Addresses

Primary practice location

500 Helendale Rd Ste 100
Rochester, NY 14609-3109

Mailing address

500 Helendale Rd Ste 100
Rochester, NY 14609-3109
Phone (585) 266-5420

Other identifiers 1

IdentifierTypeStateIssuer
1346219953MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address earthur@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823000983 NY Part B Supplier - Clinic/Group Practice 6901870294 Receives reassigned benefits from 8 practitioners
Practice locations: Rochester, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1067744Helendale Dermatology & Medical Spa500 Helendale Road Suite 100, Rochester, NY 14609Provider-performed microscopyApr 30, 2027

National Provider Directory

National Provider Directory

Locations

500 Helendale Rd
Ste 100
Rochester, NY 14609
Phone (585) 266-5420

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1396913489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HELENDALE RD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093109",
            "telephone_number": "585-266-5420",
            "fax_number": "585-266-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HELENDALE RD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093109",
            "telephone_number": "585-266-5420",
            "fax_number": "585-266-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELENDALE DERMATOLOGY & MEDICAL SPA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "ARTHUR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-266-5420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "199172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346219953",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "earthur@directaddress.net",
            "affiliation": "N",
            "address_1": "500 Helendale Rd Ste 100",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146093109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.