Individual provider Active NPI

Alan S Cassara, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, NY
National Provider Identifier
1518172063
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
033748-1 Issued in NY
Practice address
2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323
Phone
(585) 254-5360
Fax
(585) 254-8200
NPI assigned
May 10, 2007
Last updated
May 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 033748-1 NY Primary

Addresses

Primary practice location

2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323

Mailing address

2005 Lyell Ave
Suite 210
Rochester, NY 14606-2323
Phone (585) 254-5360

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001512 NY Practitioner - Oral Surgery 0840316352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033748-1NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Stonegate Oral Surgery, LLP Oral and Maxillofacial Surgery CurrentSince Jul 29, 2010 Accepting new patients

Locations

2005 Lyell Ave
Ste 210
Rochester, NY 14606
Phone (585) 254-5360

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1518172063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "address_2": "SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-254-5360",
            "fax_number": "585-254-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 LYELL AVE",
            "address_2": "SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062323",
            "telephone_number": "585-254-5360",
            "fax_number": "585-254-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSARA",
        "first_name": "ALAN",
        "middle_name": "S",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "033748-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.