NPIMap

Organization Active NPI

Pediatric Group Univ of Rochester

  • Pediatrics Physician
  • Rochester, NY
National Provider Identifier
1821029463
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC GROUP UNIV OF ROCHESTER
Practice address
601 Elmwood Ave
Box 635
Rochester, NY 14642-0001
Phone
(585) 275-7787
NPI assigned
Jul 5, 2006
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 121

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 121

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040331001273 NY Part B Supplier - Clinic/Group Practice 5496747362 Receives reassigned benefits from 96 practitioners
2 other NPIs on this enrollment
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

601 Elmwood Ave
#612
Rochester, NY 14642
Phone (585) 275-4786

125 Lattimore Rd
Ste 140
Rochester, NY 14620
Phone (585) 244-9720

601 Elmwood Ave
#632
Rochester, NY 14642
Phone (585) 275-2821

601 Elmwood Ave
Ste 777
Rochester, NY 14642

275 Lake Ave
Rochester, NY 14608
Phone (585) 935-7802

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

NPPES NPI Registry

Primary practice location

601 Elmwood Ave
Box 635
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box 635
Rochester, NY 14642-0001
Phone (585) 275-7787

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00512758MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 24, 2019.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1821029463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 635",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 635",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GROUP UNIV OF ROCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-01-24",
        "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": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00512758",
            "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 24, 2019; 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.