Individual provider Active NPI

Jeffrey Saunders Trumbull, RPA-C

  • Physician Assistant
  • Canandaigua, NY
National Provider Identifier
1790722114
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002051 Issued in NY
Practice address
185 Gibson St
Suite 100
Canandaigua, NY 14424-1340
Phone
(585) 396-2863
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2051 NY
Physician Assistant 363A00000X 002051 NY Primary

Addresses

Primary practice location

185 Gibson St
Suite 100
Canandaigua, NY 14424-1340

Mailing address

185 Gibson St
Suite 100
Canandaigua, NY 14424-1340

Other identifiers 3

IdentifierTypeStateIssuer
112350CUOtherNYPREFERRED CARE
019002051OtherNYEXCELLUS ROCHESTER
923296001OtherNYHEALTHNOW

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jtrumbull134616@direct.urmc.rochester.edu Direct
Direct Messaging Address jtrumbull134616@direct.urmc.rochester.edu Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000154 NY Practitioner - Physician Assistant 8921143389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2051NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Nov 17, 2017 Accepting new patients

Locations

350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000

229 Parrish St
Ste 100
Canandaigua, NY 14424
Phone (585) 394-0116

73 Buffalo St
Ste 100
Canandaigua, NY 14424

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

Interoperability endpoints

  • Direct secure messaging: jtrumbull134616@direct.urmc.rochester.edu

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1790722114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 GIBSON ST",
            "address_2": "SUITE 100",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 GIBSON ST",
            "address_2": "SUITE 100",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241340",
            "telephone_number": "585-396-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMBULL",
        "first_name": "JEFFREY",
        "middle_name": "SAUNDERS",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "2051",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "112350CU",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS ROCHESTER",
            "identifier": "019002051",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW",
            "identifier": "923296001",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtrumbull134616@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtrumbull134616@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.