Active NPI
Teodoro Reyes Mariano Jr., M.D.
- Cardiovascular Disease Physician
- Rochester, NY
National Provider Identifier
1477577583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 129789
- Practice address
- 800 Spencerport Rd
Rochester, NY 14606-4820 - Phone
- (585) 510-3883
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 129789 | NY | Primary |
| Internal Medicine Physician | 207R00000X | 129789 | NY |
Addresses
Primary practice location
800 Spencerport Rd
Rochester, NY 14606-4820
Mailing address
800 Spencerport Rd
Rochester, NY 14606-4820
Phone (585) 510-3883
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 444111502 | Other | NY | UNITED HEALTHCARE PPO |
| MD1826 | Other | NY | PREFERRED CARE PROVIDER |
| 80121911498001 | Other | NY | BCBS OF WESTERN NY |
| 5339337 | Other | NY | AETNA PPO |
| P010129789 | Other | NY | BLUE CHOICE PROVIDER NO. |
| 224911 | Other | NY | NYS WORKERS COMP |
| 2564331 | Other | NY | AETNA HMO |
| 0524 | Other | NY | BLUE CROSS BLUE SHIELD |
| 100768BJ | Other | NY | PREFERRED CARE PROVIDER |
| MD2826 | Other | NY | PREFERRED CARE CARDIOLOGY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
800 Spencerport Rd
Rochester, NY 14606-4820
Phone (585) 510-3883
Hospital & facility affiliations
- Rochester General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129789 | NY | MD | Cardiovascular Disease Physician |
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Brockport, NY
- NPI 1144434408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1477577583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 SPENCERPORT RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146064820",
"telephone_number": "585-510-3883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SPENCERPORT RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146064820",
"telephone_number": "585-510-3883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANO",
"first_name": "TEODORO",
"middle_name": "REYES",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "129789",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "129789",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PPO",
"identifier": "444111502",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE PROVIDER",
"identifier": "MD1826",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF WESTERN NY",
"identifier": "80121911498001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5339337",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE PROVIDER NO.",
"identifier": "P010129789",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS WORKERS COMP",
"identifier": "224911",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2564331",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0524",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE PROVIDER",
"identifier": "100768BJ",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE CARDIOLOGY",
"identifier": "MD2826",
"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 Jan 3, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.