Active NPI
Robert E Stoddard, PA
- Physician Assistant
- Rochester, NY
National Provider Identifier
1750349072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0007281
- Practice address
- 470 Long Pond Rd
Rochester, NY 14612-3057 - Phone
- (585) 227-7600
- Fax
- (585) 227-8322
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0007281 | NY | Primary |
Addresses
Primary practice location
470 Long Pond Rd
Rochester, NY 14612-3057
Mailing address
800 Carter Street
Rochester, NY 14621
Phone (585) 336-4858
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P019000728 | Other | NY | BLUE CHOICE # |
| 9513995 | Other | NY | IHA # |
| 109297DL | Other | NY | PREFERRED CARE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0007281 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1750349072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 CARTER STREET",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14621",
"telephone_number": "585-336-4858",
"fax_number": "585-336-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 LONG POND RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146123057",
"telephone_number": "585-227-7600",
"fax_number": "585-227-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "ROBERT",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "0007281",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE #",
"identifier": "P019000728",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA #",
"identifier": "9513995",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE #",
"identifier": "109297DL",
"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 Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.