Individual provider Active NPI

Susanne Ursula Miedlich, M.D.

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1477781615
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L1587295 Issued in MI
Practice address
601 Elmwood Ave
Box Med
Rochester, NY 14642-0001
Phone
(585) 276-9980
NPI assigned
Jun 25, 2009
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 273442 NY
Internal Medicine Physician 207R00000X L1587296 MI
Internal Medicine Physician 207R00000X L1587295 MI Primary

Addresses

Primary practice location

601 Elmwood Ave
Box Med
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box Med
Rochester, NY 14642-0001
Phone (585) 276-9980

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smiedlich73498@direct.urmc.rochester.edu Direct
Direct Messaging Address smiedlich73498@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
I20140725000220 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 5193941243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endocrine Practice GroupGroup PAC ID 9436149770, 25 clinicians

Practice addresses (Care Compare)

2400 S Clinton Ave
Building H Suite 135
Rochester, NY 14618-2642
Phone (585) 275-2901

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-2901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
69.75
Promoting interoperability
100
Improvement activities
40
Cost
73.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273442NYMDRegistered Nurse
L1587295MIMDInternal Medicine Physician
L1587296MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Practice Group CurrentSince Jul 1, 2014 Accepting new patients

Locations

601 Elmwood Ave
#693
Rochester, NY 14642
Phone (585) 275-2901

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1477781615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-276-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIEDLICH",
        "first_name": "SUSANNE",
        "middle_name": "URSULA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "273442",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1587296",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "L1587295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smiedlich73498@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": "smiedlich73498@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.