Individual provider Active NPI

Edith L Dale, M.D.

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1609876838
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
182523-1 Issued in NY
Practice address
1815 S Clinton Ave Ste 620
Rochester, NY 14618-5723
Phone
(585) 319-5354
Fax
(833) 450-5339
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 182523-1 NY Primary

Addresses

Primary practice location

1815 S Clinton Ave Ste 620
Rochester, NY 14618-5723

Mailing address

1815 S Clinton Ave Ste 620
Rochester, NY 14618-5723
Phone (585) 319-5354

Other identifiers 4

IdentifierTypeStateIssuer
5433322OtherNYAETNA
101339BJOtherNYPREFERRED CARE
01404264MedicaidNY
P010182523OtherNYBLUE CHOICE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edale52133@direct.rochesterregional.org 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
I20040615001623 NY Practitioner - Internal Medicine 4284618489 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Rochester School of Medicine and Dentistry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flower City Medical Group LLPGroup PAC ID 3577003573, 3 clinicians

Practice addresses (Care Compare)

1815 S Clinton Ave
Suite 620
Rochester, NY 14618-5723
Phone (585) 319-5354

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182523-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Internal Medicine CurrentSince Aug 17, 2019 Accepting new patients
Rochester General Hospital CurrentSince Jun 5, 2012 Accepting new patients
Rochester General Hospital Internal Medicine CurrentSince Jun 5, 2012 Accepting new patients
Rochester General Hospital Internal Medicine Current Accepting new patients

Locations

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

30 Hagen Dr
Ste 300
Rochester, NY 14625
Phone (585) 381-1440

220 Linden Oaks
Ste 300
Rochester, NY 14625
Phone (585) 383-4420

1815 S Clinton Ave
Ste 620
Rochester, NY 14618
Phone (585) 319-5354

Interoperability endpoints

  • Direct secure messaging: edale52133@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 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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1609876838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 S CLINTON AVE STE 620",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185723",
            "telephone_number": "585-319-5354",
            "fax_number": "833-450-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 S CLINTON AVE STE 620",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185723",
            "telephone_number": "585-319-5354",
            "fax_number": "833-450-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "EDITH",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "182523-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5433322",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "101339BJ",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01404264",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010182523",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edale52133@direct.rochesterregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1815 S Clinton Ave Ste 620",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146185723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.