Individual provider Active NPI

Paul L Dimarco, MD

  • Urology Physician
  • Rochester, NY
National Provider Identifier
1417972605
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
150400 Issued in NY
Practice address
2615 Culver Rd
Suite 100
Rochester, NY 14609-1746
Phone
(585) 336-5320
Fax
(585) 336-9114
NPI assigned
Jul 12, 2006
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 150400 NY Primary

Addresses

Primary practice location

2615 Culver Rd
Suite 100
Rochester, NY 14609-1746

Mailing address

2615 Culver Rd
Suite 100
Rochester, NY 14609-1746
Phone (585) 336-5320

Other identifiers 1

IdentifierTypeStateIssuer
1033696MedicaidNY

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
I20110518000177 NY Practitioner - Urology 5092991588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150400NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Jan 1, 2017 Accepting new patients

Locations

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

1415 Portland Ave
Ste 400
Rochester, NY 14621
Phone (585) 922-4200

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

2420 Ridgeway Ave
Rochester, NY 14626
Phone (585) 227-4000

2615 Culver Rd
Ste 100
Rochester, NY 14609
Phone (585) 336-5320

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1417972605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CULVER RD",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146091746",
            "telephone_number": "585-336-5320",
            "fax_number": "585-336-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CULVER RD",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146091746",
            "telephone_number": "585-336-5320",
            "fax_number": "585-336-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "150400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.