Individual provider Active NPI

Maria Rosa Cordisco, M.D.

  • Pediatric Dermatology Physician
  • Rochester, NY
National Provider Identifier
1700217544
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
270941 Issued in NY
Practice address
601 Elmwood Ave
Box 697
Rochester, NY 14642-0001
Phone
(585) 275-3872
NPI assigned
Dec 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 270941 NY
Pediatric Dermatology Physician 207NP0225X 270941 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Box 697
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box 697
Rochester, NY 14642-0001
Phone (585) 275-3872

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
I20141107000730 NY Practitioner - Dermatology 5799918017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270941NYMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Current Accepting new patients
University Dermatology Associates CurrentSince Jul 3, 2014 Accepting new patients
University of Rochester CurrentSince Jun 1, 2018 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University Dermatology Associates CurrentSince Jul 3, 2014 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jun 1, 2018 Accepting new patients

Locations

601 Elmwood Ave
#697
Rochester, NY 14642
Phone (585) 273-4412

40 Celebration Dr
Rochester, NY 14620
Phone (585) 275-0193

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1700217544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 697",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 697",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDISCO",
        "first_name": "MARIA",
        "middle_name": "ROSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "270941",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NY",
            "license": "270941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.