Individual provider Active NPI

Allen Danforth Pettee, M.D.

  • Neurology Physician
  • Rochester, NY
National Provider Identifier
1780671511
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
199685 Issued in NY
Practice address
2101 Lac de Ville Blvd
Rochester, NY 14618-5643
Phone
(585) 546-7266
Fax
(585) 232-5158
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 199685 NY Primary

Addresses

Primary practice location

2101 Lac de Ville Blvd
Rochester, NY 14618-5643

Mailing address

2101 Lac de Ville Blvd
Rochester, NY 14618-5643
Phone (585) 546-7266

Other identifiers 1

IdentifierTypeStateIssuer
01642644MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000745 NY Practitioner - Neurology 7315078847 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Sep 1, 2014 Accepting new patients
Rochester General Hospital CurrentSince Sep 1, 2014 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Mar 1, 2016 Accepting new patients
Rochester General Hospital Current Accepting new patients
Greater Rochester Neurological Associates, PC Neurology CurrentSince Apr 11, 2010 Accepting new patients

Locations

2619 Culver Rd
Rochester, NY 14609
Phone (585) 266-0061

2101 Lac de Ville Blvd
Rochester, NY 14618
Phone (585) 244-1150

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1780671511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185643",
            "telephone_number": "585-546-7266",
            "fax_number": "585-232-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185643",
            "telephone_number": "585-546-7266",
            "fax_number": "585-232-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEE",
        "first_name": "ALLEN",
        "middle_name": "DANFORTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "199685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01642644",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.