Individual provider Active NPI

Colleen Fogarty, MD, MSC.

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1801816954
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
193267 Issued in NY
Practice address
322 Lake Ave
Rochester, NY 14608-1017
Phone
(585) 254-6480
Fax
(585) 254-1092
NPI assigned
Jul 20, 2006
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 193267 NY Primary

Addresses

Primary practice location

322 Lake Ave
Rochester, NY 14608-1017

Mailing address

480 Genesee St
Rochester, NY 14611-3634
Phone (585) 254-6480

Other identifiers 4

IdentifierTypeStateIssuer
P010193267OtherNYBLUE CHOICE ROCHESTER
102744BFOtherNYPREFERRED CARE
193267MedicaidNY
P010193267OtherNYBLUE CROSS ROCHESTER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cfogarty3968@direct.urmc.rochester.edu Direct
Direct Messaging Address cfogarty3968@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001242 NY Practitioner - Family Practice 0143219824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Connecticut School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Highland Hospital of RochesterGroup PAC ID 5496641631, 403 clinicians

Practice addresses (Care Compare)

470 Collins St
Avon, NY 14414-1466
Phone (585) 226-2640

777 Clinton Ave S
Rochester, NY 14620-1448
Phone (585) 279-4680

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Mar 15, 2004 Accepting new patients
Highland Hospital of Rochester CurrentSince Mar 15, 2004 Accepting new patients
Highland Hospital of Rochester Family Medicine Past Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

777 Clinton Ave S
Rochester, NY 14620
Phone (585) 279-4790

82 Holland St
Rochester, NY 14605
Phone (585) 423-5800

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1801816954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GENESEE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113634",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081017",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "COLLEEN",
        "credential": "MD, MSC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "193267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE ROCHESTER",
            "identifier": "P010193267",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "102744BF",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193267",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ROCHESTER",
            "identifier": "P010193267",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cfogarty3968@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": "cfogarty3968@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 Rochester, NY

Sources for this page

Verify at the official NPI Registry.