Individual provider Active NPI

Phillip Samuel Demarco

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1881318830
Registry record updated Mar 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350566 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3011
Phone
(585) 922-4000
NPI assigned
Oct 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350566 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3011

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-1203

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
I20221214002445 NY Practitioner - Nurse Practitioner 2264801273 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians
Strong Medical GroupGroup PAC ID 6608850987, 48 clinicians
Lattimore Primary Care Medicine PLLCGroup PAC ID 6800020793, 4 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

2561 Lac de Ville Blvd
Suite 200
Rochester, NY 14618-5645
Phone (585) 473-3900

560 White Spruce Blvd
Rochester, NY 14623-1613
Phone (585) 271-5275

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Nov 7, 2022 Accepting new patients
Rochester General Hospital Current Accepting new patients
Lattimore Primary Care Medicine, PLLC CurrentSince Mar 24, 2025 Accepting new patients
Rochester General Hospital CurrentSince Nov 7, 2022 Accepting new patients
Strong Medical Group CurrentSince Mar 1, 2026 Accepting new patients

Locations

3669 Countryside Ln
Marion, NY 14505
Phone (315) 926-7733

2561 Lac de Ville Blvd
Ste 200
Rochester, NY 14618
Phone (585) 473-3900

601 Elmwood Ave
#320
Rochester, NY 14642

560 White Spruce Blvd
Rochester, NY 14623
Phone (585) 271-5250

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 5

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711756800000",
    "number": "1881318830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213011",
            "telephone_number": "585-922-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "PHILLIP",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2024-03-30",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350566",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.