Podiatry Affiliate of Rochester PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PODIATRY AFFILIATE OF ROCHESTER PLLC

Practice address

1500 Portland Avenue
Podiatry/Medical Suite
Rochester, NY 14621-3065

Phone

(585) 642-6100

Fax

(585) 642-6111

NPI assigned

Nov 7, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John Ellie Jr., DPMNPI 1427311455

Title

Ceo/President

Phone

(585) 642-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• John Ellie Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Rochester, NY
  • NPI 1427311455

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1710490263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "address_2": "PODIATRY SUITE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213065",
            "telephone_number": "585-642-6100",
            "fax_number": "585-642-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "address_2": "PODIATRY/MEDICAL SUITE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213065",
            "telephone_number": "585-642-6100",
            "fax_number": "585-642-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY AFFILIATE OF ROCHESTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "ELLIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "585-642-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05448155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin James Plow, COTA
• Benjamin Forest Plucknette, D.O.
• Robert F Plunkett Jr., D.C.
• Pluta Family Cancer Center
• Carol Ann Podgorski, PHD, MS MFT
• Podiatry Associates of Rochester, LLP
• Podiatry Associates of Rochester, LLP
• Podiatry Associates of Rochester, LLP
• Melissa Podkulski
• Jenna Podlucky, FNP

• Foot & Ankle Surgery Podiatrist in Rochester, NY
• Providers in Rochester, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.