Individual provider Active NPI

James Prezzano, M.D.

  • Dermatology Physician
  • Fayetteville, NY
National Provider Identifier
1538554753
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
284835 Issued in NY
Practice address
212 Highbridge St Ste a
Fayetteville, NY 13066-1981
Phone
(315) 637-9116
Fax
(315) 637-0436
NPI assigned
Apr 3, 2015
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 284835 NY Primary

Addresses

Primary practice location

212 Highbridge St Ste a
Fayetteville, NY 13066-1981

Mailing address

212 Highbridge St Ste a
Fayetteville, NY 13066-1981
Phone (315) 637-9116

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-5746

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
I20210807000041 NY Practitioner - Dermatology 9537469911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Rochester School of Medicine and Dentistry, 2021
Medicare assignment
May accept Medicare assignment
Group practices
James C Prezzano, M.D. P.L.L.C.Group PAC ID 1456755875, 3 clinicians

Practice addresses (Care Compare)

212 Highbridge St
Suite a
Fayetteville, NY 13066-1981
Phone (315) 637-9116

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
88.41
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision124
Removal of skin lesions2142
Removal of skin cancer327
Removal or shaving of skin growth632
Skin biopsy105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284835NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James C Prezzano MD PLLC Dermatology CurrentSince Jul 1, 2021 Accepting new patients
William G. Patrick, M.D., P.C. PastSince Jul 1, 2021 Accepting new patients

Locations

212 Highbridge St
Ste A
Fayetteville, NY 13066
Phone (315) 637-9116

Interoperability endpoints

  • Direct secure messaging: jprezzano@fayettevillederm.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1538554753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST STE A",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-9116",
            "fax_number": "315-637-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST STE A",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-9116",
            "fax_number": "315-637-0436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "14642",
            "country_code": "US",
            "telephone_number": "585-275-5746",
            "fax_number": "585-275-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREZZANO",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2021-07-16",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "284835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.