Individual provider Active NPI

Jeannine L. Dolan, M.D.

  • Family Medicine Physician
  • Penfield, NY
National Provider Identifier
1689761454
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
205850 Issued in NY
Practice address
2200 Penfield Rd
Penfield, NY 14526-1711
Phone
(585) 922-0460
NPI assigned
Oct 5, 2006
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 205850 NY Primary

Addresses

Primary practice location

2200 Penfield Rd
Penfield, NY 14526-1711

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

5973 Walworth Rd
Ontario, NY 14519-9592
Phone (315) 524-2881

Other identifiers 1

IdentifierTypeStateIssuer
080164433OtherNYRAILROAD MEDICARE PTAN (PIN)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110131000260 NY Practitioner - Family Practice 8820006091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

2200 Penfield Rd
Penfield, NY 14526-1711
Phone (585) 922-0060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
205850NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Jul 14, 2025 Accepting new patients
Rochester General Hospital CurrentSince Jul 14, 2025 Accepting new patients
Rochester General Hospital Family Medicine Current Accepting new patients

Locations

2200 Penfield Rd
Penfield, NY 14526
Phone (585) 377-6170

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Interoperability endpoints

  • Direct secure messaging: asorensen420099@direct.rochesterregional.org
  • Direct secure messaging: jeannine.dolan@nealsmithmd.chartmakerdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1689761454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PENFIELD RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261711",
            "telephone_number": "585-922-0460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5973 Walworth Rd",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "NY",
            "postal_code": "145199592",
            "country_code": "US",
            "telephone_number": "315-524-2881",
            "fax_number": "315-524-2231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "JEANNINE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "205850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN (PIN)",
            "identifier": "080164433",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.