Individual provider Active NPI

Marni Rathbun

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1558068841
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032920 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4164
Phone
(585) 723-7870
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 032920 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4164

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

200 Highridge Dr
Syracuse, NY 13215-1516
Phone (315) 956-5201

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130001458 NY Practitioner - Physician Assistant 8123557527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 429-2289

1565 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7366

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

Hospital & facility affiliations

  • Unity Hospital Hospital, Rochester, NY, CCN 330226

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032920NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Dec 9, 2024 Accepting new patients
Rochester General Hospital CurrentSince Dec 9, 2024 Accepting new patients
Rochester General Hospital CurrentSince Dec 9, 2024 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 5

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 7

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1558068841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264164",
            "telephone_number": "585-723-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Highridge Dr",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132151516",
            "country_code": "US",
            "telephone_number": "315-956-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATHBUN",
        "first_name": "MARNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.