Organization Active NPI

University Otolaryngology Associates

  • Otolaryngology Physician
  • Rochester, NY
National Provider Identifier
1679518088
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
UNIVERSITY OTOLARYNGOLOGY ASSOCIATES
Practice address
2365 S Clinton Ave
Suite 200
Rochester, NY 14618-2645
Phone
(585) 758-5700
Fax
(585) 758-1293
NPI assigned
Jun 19, 2006
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 of Finance Urmfg
Phone
(585) 756-4008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

2365 S Clinton Ave
Suite 200
Rochester, NY 14618-2645

Mailing address

601 Elmwood Ave Box 629
Rochester, NY 14642-0001
Phone (585) 758-5700

Other identifiers 1

IdentifierTypeStateIssuer
G182467590OtherNYBLUE CHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129000089 NY Part B Supplier - Clinic/Group Practice 2860395795 Receives reassigned benefits from 43 practitioners
Practice locations: Geneseo, NY; Wellsville, NY; Rochester, NY; Pittsford, NY; Geneva, NY; Canandaigua, NY; Batavia, NY

National Provider Directory

National Provider Directory

Locations

50 E South St
Ste B
Geneseo, NY 14454

2 Ryan Dr
Geneseo, NY 14454

64 Elizabeth Blackwell St
Geneva, NY 14456
Phone (315) 789-2153

2300 W Jefferson Rd
Fl 1
Pittsford, NY 14534

2337 S Clinton Ave
Rochester, NY 14618
Phone (585) 275-3524

60 Greece Center Dr
Ste 2
Rochester, NY 14612

601 Elmwood Ave
#629
Rochester, NY 14642
Phone (585) 276-5181

1561 Long Pond Rd
Ste 402
Rochester, NY 14626
Phone (716) 732-9100

Practitioners & affiliated clinicians

Practitioners 69

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

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1679518088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 629",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-758-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 S CLINTON AVE",
            "address_2": "SUITE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182645",
            "telephone_number": "585-758-5700",
            "fax_number": "585-758-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OTOLARYNGOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "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 OF FINANCE URMFG",
        "authorized_official_telephone_number": "585-756-4008"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "G182467590",
            "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.