Individual provider Active NPI

Izabela Teresa Jedrysiak, M.D.

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1467804203
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301097 Issued in NY
Practice address
454 E Broad St Ste 100
Rochester, NY 14607-1724
Phone
(585) 276-7640
Fax
(585) 325-4255
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 301097 NY Primary

Addresses

Primary practice location

454 E Broad St Ste 100
Rochester, NY 14607-1724

Mailing address

454 E Broad St Ste 100
Rochester, NY 14607-1724
Phone (585) 276-7640

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address isubczynska103540@direct.urmc.rochester.edu Direct
Direct Messaging Address isubczynska103540@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
I20191016003130 NY Practitioner - Family Practice 7517210412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2400 Clinton S Ave F
Rochester, NY 14618-2668
Phone (585) 244-7200

2400 Clinton S Ave G
Rochester, NY 14618-2668
Phone (585) 341-7685

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

2400 S Clinton Ave
BLDG H
Rochester, NY 14618-2668
Phone (585) 341-7200

454 E Broad St
Suite 100
Rochester, NY 14607-1724
Phone (585) 276-7640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Oct 7, 2019 Accepting new patients
University of Rochester CurrentSince Oct 7, 2019 Accepting new patients

Locations

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

454 E Broad St
#100
Rochester, NY 14607
Phone (585) 276-7640

777 Clinton Ave S
Rochester, NY 14620
Phone (585) 279-4790

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

Interoperability endpoints

  • Direct secure messaging: isubczynska103540@direct.urmc.rochester.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1467804203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 E BROAD ST STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071724",
            "telephone_number": "585-276-7640",
            "fax_number": "585-325-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 E BROAD ST STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071724",
            "telephone_number": "585-276-7640",
            "fax_number": "585-325-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDRYSIAK",
        "first_name": "IZABELA",
        "middle_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "isubczynska103540@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": "isubczynska103540@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.