Individual provider Active NPI

Jacqueline Breese, PA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1649926395
Registry record updated Jul 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029275 Issued in NY
Practice address
959 Panorama TRL S Ste 100
Rochester, NY 14625-2382
Phone
(585) 276-9361
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 29275 NY
Physician Assistant 363A00000X 029275 NY Primary

Addresses

Primary practice location

959 Panorama TRL S Ste 100
Rochester, NY 14625-2382

Mailing address

959 Panorama TRL S Ste 100
Rochester, NY 14625-2382
Phone (585) 276-9361

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbreese245966@direct.urmc.rochester.edu Direct
Direct Messaging Address jbreese245966@direct.urmc.rochester.edu Direct

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
I20221128000397 NY Practitioner - Physician Assistant 8921476805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2400 Clinton S Ave F
Rochester, NY 14618-2668
Phone (585) 244-7200

2400 Clinton S Ave G
Rochester, NY 14618-2668
Phone (585) 341-7685

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

2400 S Clinton Ave
BLDG H
Rochester, NY 14618-2668
Phone (585) 341-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
29275NYMDInternal Medicine Physician
029275NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Nov 1, 2022 Accepting new patients
University of Rochester Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Nov 6, 2023 Accepting new patients
University of Rochester Internal Medicine PastSince Dec 18, 2022 Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

959 Panorama Trl S
Ste 100
Rochester, NY 14625
Phone (585) 275-9361

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

Interoperability endpoints

  • Direct secure messaging: jbreese245966@direct.urmc.rochester.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689984000000",
    "number": "1649926395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 PANORAMA TRL S STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252382",
            "telephone_number": "585-276-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 PANORAMA TRL S STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252382",
            "telephone_number": "585-276-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREESE",
        "first_name": "JACQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2023-07-22",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "29275",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbreese245966@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbreese245966@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.