Individual provider Active NPI

Ethan O'Brien Murdock

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1629915681
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383940 Issued in NY
Practice address
200 E River Rd
Rochester, NY 14623-1212
Phone
(585) 275-2808
NPI assigned
Apr 29, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 865061 NY
Pediatric Nurse Practitioner 363LP0200X 383940 NY Primary

Addresses

Primary practice location

200 E River Rd
Rochester, NY 14623-1212

Mailing address

601 Elmwood Ave
Box 278984
Rochester, NY 14642-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
865061NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
U of R Neurology Department Past Accepting new patients

Organizations & group practices 1

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": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629915681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 278984",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E RIVER RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231212",
            "telephone_number": "585-275-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "ETHAN",
        "middle_name": "O'BRIEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "865061",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.