Individual provider Active NPI

Jonathan Redditt, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NY
National Provider Identifier
1467835777
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
060970 Issued in NY
Practice address
1455 E Ridge Rd
Rochester, NY 14621-2006
Phone
(585) 922-4103
Fax
(585) 922-4495
NPI assigned
Jul 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 060970 NY Primary

Addresses

Primary practice location

1455 E Ridge Rd
Rochester, NY 14621-2006

Mailing address

1455 E Ridge Rd
Rochester, NY 14621-2006
Phone (585) 922-4103

Other practice location 1

2060 Fairport Nine Mile Point Rd
Penfield, NY 14526-1749
Phone (585) 377-5810

Other practice location 2

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4103

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathan.redditt@rochesterregional.org

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200728003604 NY Practitioner - Oral Surgery 5496170193 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Case Western University School of Dental Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

1455 E Ridge Rd
Rochester, NY 14621-2006
Phone (585) 922-5033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Aug 3, 2020 Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Jul 17, 2025 Accepting new patients
The Unity Hospital of Rochester CurrentSince Aug 3, 2020 Accepting new patients
Rochester General Hospital CurrentSince Aug 3, 2020 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital Past Accepting new patients
The Unity Hospital of Rochester Past Accepting new patients
Western New York Medical Practice P.C. Past Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

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

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

1455 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-4103

1425 Portland Ave
#304
Rochester, NY 14621
Phone (585) 922-0866

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Interoperability endpoints

  • Direct secure messaging: jredditt303648@direct.rochesterregional.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1467835777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212006",
            "telephone_number": "585-922-4103",
            "fax_number": "585-922-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212006",
            "telephone_number": "585-922-4103",
            "fax_number": "585-922-4495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2060 Fairport Nine Mile Point Rd",
            "address_purpose": "LOCATION",
            "city": "Penfield",
            "state": "NY",
            "postal_code": "145261749",
            "country_code": "US",
            "telephone_number": "585-377-5810",
            "fax_number": "585-377-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213011",
            "country_code": "US",
            "telephone_number": "585-922-4103",
            "fax_number": "585-922-4495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDITT",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "060970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.redditt@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1455 E Ridge Rd",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146212006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.