Individual provider Active NPI

Bryan J Stanistreet, MD

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1598021677
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
276576 Issued in NY
Practice address
3101 W Ridge Rd BLDG C
Rochester, NY 14626
Phone
(585) 225-1700
Fax
(585) 225-1439
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 276576 NY Primary

Addresses

Primary practice location

3101 W Ridge Rd BLDG C
Rochester, NY 14626

Mailing address

3101 W Ridge Rd BLDG C
Rochester, NY 14626-3249
Phone (585) 225-1700

Other practice location 1

30 Hagen Dr Ste 310
Rochester, NY 14625-2658
Phone (585) 974-5330

Other identifiers 1

IdentifierTypeStateIssuer
04450506MedicaidNY

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
I20160707001631 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 7315244050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Rochester School of Medicine and Dentistry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

30 Hagen Dr
Rochester, NY 14625-2658
Phone (585) 242-9450

Hospital & facility affiliations

  • Rochester Regional Health Home Care Home health agency, Rochester, NY, CCN 337066
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276576NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Jun 25, 2016 Accepting new patients
Western New York Medical Practice P.C CurrentSince Sep 28, 2020 Accepting new patients
Highland Hospital of Rochester Internal Medicine CurrentSince Jun 25, 2016 Accepting new patients
Western New York Medical Practice P.C. Internal Medicine CurrentSince Sep 28, 2020 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients

Locations

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

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

913 Culver Rd
Rochester, NY 14609
Phone (585) 654-5432

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

30 Hagen Dr
Ste 310
Rochester, NY 14625
Phone (585) 641-0400

Interoperability endpoints

  • Direct secure messaging: bstanistreet306911@direct.rochesterregional.org

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 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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1598021677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W RIDGE RD BLDG C",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146263249",
            "telephone_number": "585-225-1700",
            "fax_number": "585-225-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W RIDGE RD BLDG C",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-225-1700",
            "fax_number": "585-225-1439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Hagen Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252658",
            "country_code": "US",
            "telephone_number": "585-974-5330",
            "fax_number": "585-974-5339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANISTREET",
        "first_name": "BRYAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04450506",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.