Active NPI
Ped Physical Disabilities
- Neurological Surgery Physician
- Rochester, NY
National Provider Identifier
1508809872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- PED PHYSICAL DISABILITIES
- Practice address
- 601 Elmwood Ave
Box 635
Rochester, NY 14642-0001 - Phone
- (585) 275-7787
- NPI assigned
- Jun 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Knebel
- Title
- Billing Manager
- Phone
- (585) 275-7787
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | Primary | ||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | |||
| Urology Physician | 208800000X |
Addresses
Primary practice location
601 Elmwood Ave
Box 635
Rochester, NY 14642-0001
Mailing address
601 Elmwood Ave
Box 635
Rochester, NY 14642-0001
Phone (585) 275-7787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00512758 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
601 Elmwood Ave
#671
Rochester, NY 14642
Phone (585) 275-2986
2617 East Ave
Rochester, NY 14610
Phone (585) 504-4167
101 E Henrietta Rd
Rochester, NY 14620
Phone (585) 244-0570
1000 Elmwood Ave
Ste 100
Rochester, NY 14620
Phone (585) 271-2897
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Rochester, NY
- NPI 1255787990
-
- Developmental - Behavioral Pediatrics Physician
- Rochester, NY
- NPI 1407219918
-
- Developmental - Behavioral Pediatrics Physician
- Rochester, NY
- NPI 1891966503
-
- Pediatric Neurodevelopmental Disabilities Physician
- Rochester, NY
- NPI 1306191119
-
- Developmental - Behavioral Pediatrics Physician
- Syracuse, NY
- NPI 1720090277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1508809872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"address_2": "BOX 635",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-275-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"address_2": "BOX 635",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-275-7787"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PED PHYSICAL DISABILITIES",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-14",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "KNEBEL",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "585-275-7787"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00512758",
"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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.