Individual provider Active NPI

Rita A Clement, MD

  • Obstetrics & Gynecology Physician
  • Rochester, NY
National Provider Identifier
1508834201
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
201021 Issued in NY
Practice address
990 South Avenue
Suite 104
Rochester, NY 14620
Phone
(585) 256-3000
Fax
(585) 256-3045
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 201021 NY Primary

Addresses

Primary practice location

990 South Avenue
Suite 104
Rochester, NY 14620

Mailing address

990 South Avenue
Suite 104
Rochester, NY 14620
Phone (585) 256-3000

Other identifiers 4

IdentifierTypeStateIssuer
5361700OtherAETNA
101611CKOtherNYPREFERRED CARE
10474003OtherCAQH
01852088MedicaidNY

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
I20100324000083 NY Practitioner - Obstetrics/Gynecology 2567597990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Rochester School of Medicine and Dentistry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast OB-GYN PCGroup PAC ID 9931234358, 5 clinicians

Practice addresses (Care Compare)

990 S Ave
Suite 104
Rochester, NY 14620-2740
Phone (585) 256-3000

Hospital & facility affiliations

  • Highland Hospital Hospital, Rochester, NY, CCN 330164
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201021NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast OB-GYN PC Obstetrics & Gynecology CurrentSince Jul 1, 2000 Accepting new patients
Highland Hospital of Rochester Past Accepting new patients

Locations

990 South Ave
Ste 104
Rochester, NY 14620
Phone (585) 256-3000

Organizations & group practices 2

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.

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508834201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SOUTH AVENUE",
            "address_2": "SUITE 104",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-256-3000",
            "fax_number": "585-256-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SOUTH AVENUE",
            "address_2": "SUITE 104",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-256-3000",
            "fax_number": "585-256-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "RITA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "201021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5361700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "101611CK",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10474003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01852088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.