Individual provider Active NPI

Patricia Renee Mallaber, DNP, ANP-BC

  • Adult Health Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1851610026
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
305384 Issued in NY
Practice address
125 Red Creek Dr
Rochester, NY 14623-4272
Phone
(585) 486-0600
Fax
(585) 273-5761
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 305384 NY
Adult Health Nurse Practitioner 363LA2200X 305384 NY Primary

Addresses

Primary practice location

125 Red Creek Dr
Rochester, NY 14623-4272

Mailing address

601 Elmwood Ave
Wilmot Cancer Center Box 704
Rochester, NY 14642-0001
Phone (585) 275-5823

Other names 1

  • Ms. Patricia Renee Sanford Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pmallaber46571@direct.urmc.rochester.edu Direct
Direct Messaging Address pmallaber46571@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
I20140520001961 NY Practitioner - Nurse Practitioner 3476776485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305384NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jul 1, 2015 Accepting new patients
Hematology Clinical Group CurrentSince Oct 16, 2023 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jul 1, 2015 Accepting new patients
University of Rochester Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients

Locations

601 Elmwood Ave
#704
Rochester, NY 14642
Phone (585) 275-5823

125 Red Creek Dr
Rochester, NY 14623
Phone (585) 486-0600

601 Elmwood Ave
#610
Rochester, NY 14642
Phone (585) 275-2881

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

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1851610026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "WILMOT CANCER CENTER BOX 704",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-5823",
            "fax_number": "585-273-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RED CREEK DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234272",
            "telephone_number": "585-486-0600",
            "fax_number": "585-273-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLABER",
        "first_name": "PATRICIA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "DNP, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "305384",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmallaber46571@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": "pmallaber46571@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": [
        {
            "first_name": "PATRICIA",
            "last_name": "SANFORD",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.