Individual provider Active NPI

Alison Elizabeth Moynihan, MD, PHD

  • Dermatology Physician
  • Rochester, NY
National Provider Identifier
1598258634
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
316818 Issued in NY
Practice address
40 Celebration Dr
Rochester, NY 14620-2664
Phone
(585) 275-7546
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 316818 NY
Dermatology Physician 207N00000X 316818 NY Primary

Addresses

Primary practice location

40 Celebration Dr
Rochester, NY 14620-2664

Mailing address

601 Elmwood Ave Box 278797
Rochester, NY 14642-0001
Phone (585) 275-7546

Other practice location 1

80 West Ave Ste 205
Brockport, NY 14420-1309
Phone (585) 275-7546

Other practice location 2

400 Red Creek Dr Ste 200
Rochester, NY 14623-4281
Phone (585) 275-7546

Other names 1

  • Alison Elizabeth Moynihan Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address agaylo101612@direct.urmc.rochester.edu Direct
Direct Messaging Address agaylo101612@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: 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
I20220707002887 NY Practitioner - Dermatology 3476933417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Rochester School of Medicine and Dentistry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Dermatology AssociatesGroup PAC ID 5698736460, 26 clinicians
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

40 Celebration Dr
Rochester, NY 14620-2664
Phone (585) 275-7546

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions518
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy278

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Aug 15, 2022 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University Dermatology Associates Dermatology CurrentSince Aug 15, 2022 Accepting new patients
University Dermatology Associates Dermatology CurrentSince Aug 15, 2022 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 15, 2022 Accepting new patients
University of Rochester Current Accepting new patients

Locations

80 West Ave
Ste 205
Brockport, NY 14420
Phone (585) 275-7546

400 Red Creek Dr
Rochester, NY 14623
Phone (585) 334-5560

601 Elmwood Ave
#278797
Rochester, NY 14642

400 Red Creek Dr
Ste 200
Rochester, NY 14623
Phone (585) 275-7546

40 Celebration Dr
Rochester, NY 14620
Phone (585) 275-0193

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

Interoperability endpoints

  • Direct secure messaging: agaylo101612@direct.urmc.rochester.edu

Organizations & group practices 7

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 3

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1598258634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 278797",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CELEBRATION DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202664",
            "telephone_number": "585-275-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 West Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Brockport",
            "state": "NY",
            "postal_code": "144201309",
            "country_code": "US",
            "telephone_number": "585-275-7546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Red Creek Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146234281",
            "country_code": "US",
            "telephone_number": "585-275-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "ALISON",
        "middle_name": "ELIZABETH",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-07-17",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "316818",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "316818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agaylo101612@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": "agaylo101612@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": [
        {
            "first_name": "ALISON",
            "last_name": "MOYNIHAN",
            "middle_name": "ELIZABETH",
            "credential": "MD, PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.