Organization Active NPI

Finger Lakes Internists

  • Internal Medicine Physician
  • Bath, NY
National Provider Identifier
1407845415
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FINGER LAKES INTERNISTS
Practice address
7603 Route 54
Bath, NY 14810-7930
Phone
(607) 776-0163
Fax
(607) 776-8032
NPI assigned
Oct 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Authorized official

Name
Rita A Trusievitz
Title
Manager
Phone
(607) 776-8032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7603 Route 54
Bath, NY 14810-7930

Mailing address

7603 Route 54
Bath, NY 14810-7930
Phone (607) 776-0163

Other identifiers 1

IdentifierTypeStateIssuer
02084559MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090626000191 NY Part B Supplier - Clinic/Group Practice 0446301808 Receives reassigned benefits from 2 practitioners
Practice locations: Bath, NY

National Provider Directory

National Provider Directory

Locations

7603 State Route 54
Bath, NY 14810
Phone (607) 776-0163

Practitioners & affiliated clinicians

Practitioners 2

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": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1407845415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7603 ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148107930",
            "telephone_number": "607-776-0163",
            "fax_number": "607-776-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7603 ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148107930",
            "telephone_number": "607-776-0163",
            "fax_number": "607-776-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FINGER LAKES INTERNISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "TRUSIEVITZ",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "607-776-8032"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084559",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.