NPIMap

Organization Active NPI

Canandaigua Medical Group, P.C.

  • Surgery Physician
  • Canandaigua, NY
National Provider Identifier
1669472973
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CANANDAIGUA MEDICAL GROUP, P.C.
Practice address
335 Parrish St
Canandaigua, NY 14424-1728
Phone
(585) 393-2888
Fax
(585) 396-9275
NPI assigned
Jul 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Ms. Bonnie L Babcock
Title
Human Resource Manager
Phone
(585) 393-2888

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NY
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X NY
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X NY
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X NY Primary

Addresses

Primary practice location

335 Parrish St
Canandaigua, NY 14424-1728

Mailing address

335 Parrish St
Canandaigua, NY 14424-1728
Phone (585) 393-2888

Other identifiers 1

IdentifierTypeStateIssuer
00458017MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669472973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241728",
            "telephone_number": "585-393-2888",
            "fax_number": "585-396-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241728",
            "telephone_number": "585-393-2888",
            "fax_number": "585-396-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANANDAIGUA MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BABCOCK",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "HUMAN RESOURCE MANAGER",
        "authorized_official_telephone_number": "585-393-2888",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00458017",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.