Upstate Regional Medical Supply ,Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

332B00000X Issued in NY

Legal business name

UPSTATE REGIONAL MEDICAL SUPPLY ,INC.

Practice address

1593 E Main St
Rochester, NY 14609-7056

Phone

(585) 243-3080

Fax

(585) 243-4406

NPI assigned

Aug 16, 2006

Organization subpart

Yes

Parent organization

UPSTATE REGIONAL MEDICAL SUPPLY, INCAs reported in NPPES

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

Authorized official

Name

Mr. Allen Scott Slack

Title

President

Phone

(585) 727-6176

Specialties & licenses 1

Addresses

Other names 1

• Heman Braces & Orthotics Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Part of

Upstate Regional Medical Supply Inc

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1568575439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E MAIN ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097056",
            "telephone_number": "585-243-3080",
            "fax_number": "585-243-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1593 E MAIN ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097056",
            "telephone_number": "585-243-3080",
            "fax_number": "585-243-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE REGIONAL MEDICAL SUPPLY ,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPSTATE REGIONAL MEDICAL SUPPLY, INC",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-727-6176",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "332B00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heman Braces & Orthotics",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Heman Braces & Orthotics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Prakash Upreti, MD
• Kerry Upshaw, CASAC
• Odell Upshaw Jr.
• Upstate Care Management Services Inc
• Upstate Ketamine Care
• Upstate Vascular Study Lab, Inc
• Kim Urbach, NP
• Urban Affairs Inc.
• Urban League of Rochester, N.Y., Inc.
• Abigail Urban-Rifkin, LMHC, CASAC

• Durable Medical Equipment & Medical Supplies in Rochester, NY
• Providers in Rochester, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.