Individual provider Active NPI

Mary Jo Spallina, CNM

  • Advanced Practice Midwife
  • Rochester, NY
National Provider Identifier
1740244649
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F001001-1 Issued in NY
Practice address
777 Canal View Blvd
Suite 400
Rochester, NY 14623
Phone
(585) 244-3430
Fax
(585) 244-2202
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F001001-1 NY Primary

Addresses

Primary practice location

777 Canal View Blvd
Suite 400
Rochester, NY 14623

Mailing address

777 Canal View Blvd
Suite 400
Rochester, NY 14623
Phone (585) 244-3430

Other identifiers 7

IdentifierTypeStateIssuer
02198227MedicaidNY
107179CQOtherNYPREFERRED CARE
1899695OtherNYGHI
P010011001OtherNYBC/BS
000923970001OtherNYBC/BS OF WESTERN NEW YORK
000923970002OtherNYBC/BS OF WESTERN NEW YORK
P010011001OtherNYBLUE CHOICE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000208 NY Practitioner - Certified Nurse Midwife (CNM) 2769659028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Rochester School of Medicine and Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Strong Obstetrics-Gynecology GroupGroup PAC ID 2860382926, 79 clinicians

Practice addresses (Care Compare)

777 Canal View Blvd
Suite 400
Rochester, NY 14623-2823
Phone (585) 244-3430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F001001-1NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Dec 1, 2024 Accepting new patients
Highland Hospital of Rochester CurrentSince Dec 1, 2024 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Strong Obstetrics-Gynecology Group Obstetrics & Gynecology CurrentSince Dec 1, 2024 Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

777 Canal View Blvd
Ste 400
Rochester, NY 14623
Phone (585) 244-3430

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

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

Interoperability endpoints

  • Direct secure messaging: mspallina7313@direct.urmc.rochester.edu

Organizations & group practices 5

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1740244649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CANAL VIEW BLVD",
            "address_2": "SUITE 400",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14623",
            "telephone_number": "585-244-3430",
            "fax_number": "585-244-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CANAL VIEW BLVD",
            "address_2": "SUITE 400",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14623",
            "telephone_number": "585-244-3430",
            "fax_number": "585-244-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALLINA",
        "first_name": "MARY JO",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F001001-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02198227",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "107179CQ",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "1899695",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "P010011001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF WESTERN NEW YORK",
            "identifier": "000923970001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF WESTERN NEW YORK",
            "identifier": "000923970002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010011001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.