NPIMap

Individual provider Active NPI

Susan Marie Polcyn-Dorgan, RPA-C

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1518987221
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006224 Issued in NY
Practice address
1000 South Ave
Rochester, NY 14620-2733
Phone
(585) 341-6395
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6224 NY
Medical Physician Assistant 363AM0700X 006224 NY Primary

Addresses

Primary practice location

1000 South Ave
Rochester, NY 14620-2733

Mailing address

62 Sableridge CT
Spencerport, NY 14559-2100
Phone (585) 352-1035

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address spolcyndorgan6368@direct.urmc.rochester.edu Direct
Direct Messaging Address spolcyndorgan6368@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129001744 NY Practitioner - Physician Assistant 1557685252 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Hospital of RochesterGroup PAC ID 5496641631, 403 clinicians
Internal Medicine GroupGroup PAC ID 3476454661, 166 clinicians

Practice addresses (Care Compare)

1000 S Ave
Rochester, NY 14620-2733

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-7424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.84 of 100Reported as group
Quality
68.36
Promoting interoperability
100
Improvement activities
40
Cost
81.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006224NYMDMental Health Counselor
6224NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Apr 1, 2017 Accepting new patients
Highland Hospital of Rochester CurrentSince Feb 8, 2017 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Highland Hospital of Rochester CurrentSince Jun 10, 2020 Accepting new patients
Highland Hospital of Rochester CurrentSince Nov 13, 2014 Accepting new patients
University of Rochester CurrentSince Apr 1, 2017 Accepting new patients
Highland Hospital of Rochester CurrentSince Nov 13, 2014 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Internal Medicine at Lakeside Past Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

156 West Ave
Brockport, NY 14420
Phone (585) 395-6095

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

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

Interoperability endpoints

  • Direct secure messaging: spolcyndorgan6368@direct.urmc.rochester.edu

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1518987221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 SABLERIDGE CT",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592100",
            "telephone_number": "585-352-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-341-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCYN-DORGAN",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "6224",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spolcyndorgan6368@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spolcyndorgan6368@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.