Individual provider Active NPI

Danielle Elizabeth Faivus Ackley, MD

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1497310437
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
601 Elmwood Avenue Box #777R
Rochester, NY 14642-0001
Phone
(585) 275-4174
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

601 Elmwood Avenue Box #777R
Rochester, NY 14642-0001

Mailing address

2257 Connell Ter
Baldwinsville, NY 13027-1030
Phone (315) 532-4569

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
I20190806002131 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6406183078

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Health Hospital, Inc. Past Accepting new patients
Neonatal Associates of Central New York PC Past Accepting new patients
Neonatal Medical Transport PLLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1497310437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 CONNELL TER",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271030",
            "telephone_number": "315-532-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE BOX #777R",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKLEY",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH FAIVUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.