Individual provider Active NPI

Victor A Poleshuck, M.D.

  • Gynecology Physician
  • Rochester, NY
National Provider Identifier
1770548281
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
102040-1 Issued in NY
Practice address
33 Woodbury PL
Rochester, NY 14618-3440
Phone
(585) 442-9291
Fax
(585) 442-9149
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 102040-1 NY Primary

Addresses

Primary practice location

33 Woodbury PL
Rochester, NY 14618-3440

Mailing address

33 Woodbury PL
Rochester, NY 14618-3440
Phone (585) 310-7595

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
102040-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Ridge Obstetrics and Gynecology, LLP PastSince Aug 16, 2005 Accepting new patients

Organizations & group practices 1

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1770548281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WOODBURY PL",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183440",
            "telephone_number": "585-310-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WOODBURY PL",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183440",
            "telephone_number": "585-442-9291",
            "fax_number": "585-442-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLESHUCK",
        "first_name": "VICTOR",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "102040-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.