Individual provider Active NPI

Paul Blackcloud, M.D.

  • Dermatology Physician
  • Rochester, NY
National Provider Identifier
1417319187
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
309252 Issued in NY
Practice address
40 Celebration Dr
Rochester, NY 14620-2664
Phone
(585) 275-7546
NPI assigned
Mar 22, 2016
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 309252 NY Primary

Addresses

Primary practice location

40 Celebration Dr
Rochester, NY 14620-2664

Mailing address

601 Elmwood Ave Box 278797
Rochester, NY 14642-5631
Phone (585) 275-7546

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pblackcloud120231@direct.urmc.rochester.edu Direct
Direct Messaging Address pblackcloud120231@direct.urmc.rochester.edu Direct

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
I20210608001001 NY Practitioner - Dermatology 8123440328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Columbia University College of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Dermatology AssociatesGroup PAC ID 5698736460, 26 clinicians
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

40 Celebration Dr
Rochester, NY 14620-2664
Phone (585) 275-7546

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16
Removal of skin lesions719
Skin biopsy253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309252NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Dermatology Associates Dermatology CurrentSince Aug 1, 2021 Accepting new patients
University of Rochester CurrentSince Aug 1, 2021 Accepting new patients
University Dermatology Associates Dermatology CurrentSince Aug 1, 2021 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 1, 2021 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Regents Univ of Calif Los Angeles PastSince Oct 1, 2020 Accepting new patients
University of Rochester Past Accepting new patients

Locations

40 Celebration Dr
Rochester, NY 14620
Phone (585) 275-0193

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#278797
Rochester, NY 14642

Interoperability endpoints

  • Direct secure messaging: pblackcloud120231@direct.urmc.rochester.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1417319187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 278797",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146425631",
            "telephone_number": "585-275-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CELEBRATION DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202664",
            "telephone_number": "585-275-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKCLOUD",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "309252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pblackcloud120231@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pblackcloud120231@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.