NPIMap

Organization Active NPI

Penfield Pediatrics, LLC

  • Pediatrics Physician
  • Penfield, NY
National Provider Identifier
1629159496
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PENFIELD PEDIATRICS, LLC
Practice address
21 Willow Pond Way
Suite 200
Penfield, NY 14526-2687
Phone
(585) 377-0840
Fax
(585) 377-9715
NPI assigned
Oct 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Cynthia Arieno
Title
Office Manager
Phone
(585) 377-8002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

21 Willow Pond Way
Suite 200
Penfield, NY 14526-2687

Mailing address

21 Willow Pond Way
Suite 200
Penfield, NY 14526-2687
Phone (585) 377-0840

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0726316Penfield Pediatrics LLC21 Willow Pond Way Suite 200, Penfield, NY 14526Provider-performed microscopyJul 31, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629159496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY",
            "address_2": "SUITE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-377-0840",
            "fax_number": "585-377-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY",
            "address_2": "SUITE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-377-0840",
            "fax_number": "585-377-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENFIELD PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARIENO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "585-377-8002"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.