Individual provider Active NPI

Jenette Helen Dziezynski, AUD

  • Audiologist
  • Rochester, NY
National Provider Identifier
1497420467
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
003041 Issued in NY
Practice address
2365 S Clinton Ave Ste 200
Rochester, NY 14618-2663
Phone
(585) 758-5700
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 003041 NY Primary

Addresses

Primary practice location

2365 S Clinton Ave Ste 200
Rochester, NY 14618-2663

Mailing address

2365 S Clinton Ave Ste 200
Rochester, NY 14618-2663
Phone (585) 758-5700

Other identifiers 1

IdentifierTypeStateIssuer
003041OtherNYNYS AUDIOLOGY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823001582 NY Practitioner - Qualified Audiologist 1153726591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003041NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Aug 6, 2021 Accepting new patients
University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 6, 2021 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients

Locations

2365 S Clinton Ave
Ste 200
Rochester, NY 14618
Phone (585) 275-0142

601 Elmwood Ave
#684
Rochester, NY 14642
Phone (585) 784-9503

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Organizations & group practices 5

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1497420467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 S CLINTON AVE STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182663",
            "telephone_number": "585-758-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 S CLINTON AVE STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182663",
            "telephone_number": "585-758-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEZYNSKI",
        "first_name": "JENETTE",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "003041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS AUDIOLOGY LICENSE",
            "identifier": "003041",
            "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 Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.