Individual provider Active NPI

Jean Bohomey, NP

  • Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1619075173
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F330435 Issued in NY
Practice address
435 E Henrietta Rd
Rochester, NY 14620-4629
Phone
(585) 760-5466
Fax
(585) 760-5467
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F330435 NY Primary

Addresses

Primary practice location

435 E Henrietta Rd
Rochester, NY 14620-4629

Mailing address

435 E Henrietta Rd
Rochester, NY 14620-4629
Phone (585) 760-5466

Other identifiers 1

IdentifierTypeStateIssuer
02564923MedicaidNY

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
I20081121000473 NY Practitioner - Nurse Practitioner 8123188091 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6822CTMDPhysician Assistant
F330435NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Gardens Corporation CurrentSince Aug 19, 2013 Accepting new patients
Highland Hospital of Rochester CurrentSince Aug 1, 2002 Accepting new patients
Highland Hospital of Rochester CurrentSince Aug 1, 2002 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Matrix Medical of New York PC Nurse Practitioner CurrentSince Sep 1, 2017 Accepting new patients
Strong Obstetrics-Gynecology Group Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

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

4646 Nine Mile Point Rd
Fairport, NY 14450
Phone (585) 377-0350

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

601 Elmwood Ave
#320
Rochester, NY 14642

1000 South Ave
Ste 116
Rochester, NY 14620
Phone (585) 341-6732

435 E Henrietta Rd
Rochester, NY 14620
Phone (585) 760-5466

3 Upton Park
Rochester, NY 14607
Phone (585) 241-2100

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1619075173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204629",
            "telephone_number": "585-760-5466",
            "fax_number": "585-760-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204629",
            "telephone_number": "585-760-5466",
            "fax_number": "585-760-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHOMEY",
        "first_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F330435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02564923",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.