Active NPI
Segundo Sergio Robert-Ibarra, M.D.
- Psychiatry Physician
- Rochester, NY
National Provider Identifier
1871718130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 319233
- Practice address
- 601 Elmwood Ave
Rochester, NY 14642-0001 - Phone
- (585) 276-4569
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 319233 | NY | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | K7031 | TX | |
| Psychiatry Physician | 2084P0800X | 319233 | NY | Primary |
Addresses
Primary practice location
601 Elmwood Ave
Rochester, NY 14642-0001
Mailing address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 276-4569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K7031 | Other | TX | TEXAS MEDICAL BOARD |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | srobertibarra292771@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | srobertibarra292771@direct.urmc.rochester.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Rochester | Current | Accepting new patients | |
| University of Rochester Department of Psychiatry Clinical Group | Internal Medicine | Current | Accepting new patients |
| University of Rochester | Internal Medicine | Current | Accepting new patients |
| University of Rochester | Internal Medicine | Current | Accepting new patients |
| University of Rochester | Past | Accepting new patients | |
| Northeast Texas Mental Health Mental Retardation Center | Past | Accepting new patients | |
| Southwest Arkansas Counseling and Mental Health Center, Inc | Past | Accepting new patients | |
| U of R Neurology Department | Past | Accepting new patients |
Locations
300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569
601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555
Interoperability endpoints
- srobertibarra292771@direct.urmc.rochester.edu
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1710226824
-
- Psychiatry Physician
- Rochester, NY
- NPI 1326088808
Internal Medicine
-
- Plastic Surgery Physician
- Corpus Christi, TX
- NPI 1568658227
-
- Community/Retail Pharmacy
- Rochester, NY
- NPI 1598476269
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1821152588
-
- Neurology Physician
- Rochester, NY
- NPI 1184725525
-
- Psychiatric Hospital Unit
- Rochester, NY
- NPI 1154482628
-
- Mental Health Counselor
- Texarkana, TX
- NPI 1568403574
-
- Community/Behavioral Health Agency
- Texarkana, AR
- NPI 1598761553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689984000000",
"number": "1871718130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-276-4569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-276-4569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERT-IBARRA",
"first_name": "SEGUNDO",
"middle_name": "SERGIO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2023-07-22",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "319233",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TX",
"license": "K7031",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "319233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS MEDICAL BOARD",
"identifier": "K7031",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "srobertibarra292771@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": "srobertibarra292771@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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.