NPIMap

Organization Active NPI

Urmc Memory Care Program

  • Neurology Physician
  • Rochester, NY
National Provider Identifier
1447565759
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
URMC MEMORY CARE PROGRAM
Practice address
315 Science Pkwy Ste 200
Rochester, NY 14620-4200
Phone
(585) 273-5454
Fax
(585) 341-7510
NPI assigned
Aug 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Jill M Hetterich
Title
Sr. Director of Finance-Urmfg
Phone
(585) 756-4008

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

315 Science Pkwy Ste 200
Rochester, NY 14620-4200

Mailing address

315 Science Pkwy Ste 200
Rochester, NY 14620-4200
Phone (585) 273-5454

Other identifiers 1

IdentifierTypeStateIssuer
03278255MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110216000446 NY Part B Supplier - Clinic/Group Practice 9335320829 Receives reassigned benefits from 14 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

315 Science Pkwy
Ste 200
Rochester, NY 14620
Phone (585) 273-5454

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1447565759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 SCIENCE PKWY STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204200",
            "telephone_number": "585-273-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SCIENCE PKWY STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204200",
            "telephone_number": "585-273-5454",
            "fax_number": "585-341-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URMC MEMORY CARE PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR. DIRECTOR OF FINANCE-URMFG",
        "authorized_official_telephone_number": "585-756-4008"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03278255",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Feb 17, 2023; 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.