Organization Active NPI

University of Rochester Pediatric Ophthalmology Services

  • Ophthalmology Physician
  • Rochester, NY
National Provider Identifier
1649428400
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
UNIVERSITY OF ROCHESTER PEDIATRIC OPHTHALMOLOGY SERVICES
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 758-7671
NPI assigned
Sep 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Jill M Hetterich
Title
Senior Director, Finance, Urmgg
Phone
(585) 756-4008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box 888
Rochester, NY 14642-0001
Phone (585) 784-9582

Other identifiers 1

IdentifierTypeStateIssuer
03104978MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090109000026 NY Part B Supplier - Clinic/Group Practice 4587727052 Receives reassigned benefits from 5 practitioners
Practice locations: Batavia, NY; Webster, NY; Rochester, NY; Geneva, NY; Geneseo, NY; Pittsford, NY

National Provider Directory

National Provider Directory

Locations

792 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-3595

160 Office Pkwy
Pittsford, NY 14534
Phone (585) 275-0378

601 Elmwood Ave
#659
Rochester, NY 14642
Phone (585) 275-0378

6534 Anthony Dr
Ste B
Victor, NY 14564
Phone (585) 398-7545

603 Ridge Rd
Webster, NY 14580
Phone (585) 276-8608

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1649428400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 888",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-784-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-758-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ROCHESTER PEDIATRIC OPHTHALMOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, FINANCE, URMGG",
        "authorized_official_telephone_number": "585-756-4008"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03104978",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.