Active NPI
John Michael Purificato, PA-C
- Physician Assistant
- Penfield, NY
National Provider Identifier
1427830306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 030812
- Practice address
- 481 Penbrooke Dr Ste 6
Penfield, NY 14526-2044 - Phone
- (585) 388-6000
- NPI assigned
- Oct 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 030812 | NY | Primary |
Addresses
Primary practice location
481 Penbrooke Dr Ste 6
Penfield, NY 14526-2044
Mailing address
18 Woodlawn Ave
Fairport, NY 14450-2120
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240226003862 | NY | Order and Referring Only - Physician Assistant | 9032554316 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1427830306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WOODLAWN AVE",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144502120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "481 PENBROOKE DR STE 6",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145262044",
"telephone_number": "585-388-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURIFICATO",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-16",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "030812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penfield, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.