NPIMap

Organization Active NPI

Endocrine Practice Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Rochester, NY
National Provider Identifier
1811946825
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINE PRACTICE GROUP
Practice address
601 Elmwood Ave
Box 693
Rochester, NY 14642-0001
Phone
(585) 275-2901
Fax
(585) 273-1288
NPI assigned
May 8, 2006
Last updated
Jan 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Jill M Hetterich
Title
Senior Director of Finance, Urmfg
Phone
(585) 756-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

601 Elmwood Ave
Box 693
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box 278911
Rochester, NY 14642-0001
Phone (585) 756-4011

Other identifiers 2

IdentifierTypeStateIssuer
G0189014590OtherNYBLCH
G458104MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001450 NY Part B Supplier - Clinic/Group Practice 9436149770 Receives reassigned benefits from 32 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

2400 S Clinton Ave
Ste H135
Rochester, NY 14618
Phone (585) 275-2901

601 Elmwood Ave
#693
Rochester, NY 14642
Phone (585) 275-2901

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1811946825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 278911",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-756-4011",
            "fax_number": "585-784-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 693",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2901",
            "fax_number": "585-273-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINE PRACTICE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF FINANCE, URMFG",
        "authorized_official_telephone_number": "585-756-4003"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLCH",
            "identifier": "G0189014590",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G458104",
            "state": "NY"
        }
    ],
    "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 Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.