Emogene H Bedrosian, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

89323 Issued in OH

Practice address

98 Stoessel Ave.
Chautauqua, NY 14722-0451

Phone

(716) 753-2061

Fax

(716) 753-2062

NPI assigned

Dec 5, 2005

Last updated

Sep 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 5

Other names 1

• Gena Lee Herzog Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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• Memorial Hospital of Geneva

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• Professional Emergency Specialists of Southern Ohio

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• Professional Emergency Specialists of Southern Ohio

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• Ues Geauga, LLC

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• University Emergency Specialists of Bedford LLC

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1780668442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "address_2": "98 STOESSEL AVE",
            "city": "CHAUTAUQUA",
            "state": "NY",
            "postal_code": "147220451",
            "telephone_number": "716-753-2061",
            "fax_number": "716-753-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 STOESSEL AVE.",
            "city": "CHAUTAUQUA",
            "state": "NY",
            "postal_code": "147220451",
            "telephone_number": "716-753-2061",
            "fax_number": "716-753-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDROSIAN",
        "first_name": "EMOGENE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "149180",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "89323",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD 021439 E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA07033400",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101222151",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME81145",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0022869",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N409522",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000381808",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2781664",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000162489",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000268968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENA",
            "last_name": "HERZOG",
            "middle_name": "LEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chautauqua Fire District # 1
• David H Jaffe, MD
• Jeanne Elizabeth Wiebenga, M.D.

• Emergency Medicine Physician in Chautauqua, NY
• Providers in Chautauqua, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.