Individual provider Active NPI

Prachi Hanwatkar, DDS MPH

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1629375506
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058345 Issued in NY
Practice address
1425 Portland Avenue
Rochester, NY 14621
Phone
(585) 922-4282
Fax
(585) 276-0293
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 058345 NY Primary

Addresses

Primary practice location

1425 Portland Avenue
Rochester, NY 14621

Mailing address

1425 Portland Avenue
Rochester, NY 14621
Phone (585) 922-4000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229001054 NY Practitioner - Dentist 9234433079 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital General Practice CurrentSince Oct 13, 2022 Accepting new patients
Rochester General Hospital CurrentSince Oct 13, 2022 Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Oct 13, 2022 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
The Unity Hospital of Rochester CurrentSince Oct 13, 2022 Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

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

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

1455 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-4103

Interoperability endpoints

  • Direct secure messaging: phanwatkar138377@direct.rochesterregional.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1629375506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4000",
            "fax_number": "585-276-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-922-4282",
            "fax_number": "585-276-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANWATKAR",
        "first_name": "PRACHI",
        "credential": "DDS MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.