Western New York Medical Practice P.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WESTERN NEW YORK MEDICAL PRACTICE P.C.

Doing business as

WNY Sports & Ortho

Practice address

2619 Culver Rd Ste 2a
Rochester, NY 14609-1738

Phone

(585) 342-2410

NPI assigned

Apr 6, 2021

Last updated

Apr 6, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

WESTERN NEW YORK MEDICAL PRACTICE P.C.As reported in NPPES

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

Authorized official

Name

Nichole S Holder

Title

Director - Payer Enrollment

Phone

(585) 922-0293

Specialties & licenses 1

Addresses

Other names 1

• WNY Sports & Ortho Doing business as

Part of

Western New York Medical Practice PC

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1497334510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 CULVER RD STE 2A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146091738",
            "telephone_number": "585-342-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEW YORK MEDICAL PRACTICE P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN NEW YORK MEDICAL PRACTICE P.C.",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR - PAYER ENROLLMENT",
        "authorized_official_telephone_number": "585-922-0293"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WNY Sports & Ortho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Rochester, NY
• Providers in Rochester, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.