Individual provider Active NPI

David Robert Prener, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1811959067
Registry record updated Sep 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F332039-1 Issued in NY
Practice address
465 Westfall Rd
Rochester, NY 14620-4645
Phone
(585) 463-2739
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F332039-1 NY Primary

Addresses

Primary practice location

465 Westfall Rd
Rochester, NY 14620-4645

Mailing address

V.a. Outpatient Clinic
465 Westfall Road
Rochester, NY 14620-4645
Phone (585) 463-2757

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
I20110311000243 NY Practitioner - Nurse Practitioner 7911189964 Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F332039-1NYMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1811959067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "V.A. OUTPATIENT CLINIC",
            "address_2": "465 WESTFALL ROAD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204645",
            "telephone_number": "585-463-2757",
            "fax_number": "585-463-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WESTFALL RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204645",
            "telephone_number": "585-463-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENER",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F332039-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.