Active NPI
Edward A Sassaman, MD
- Pediatrics Physician
- Rochester, NY
National Provider Identifier
1881638740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 197323
- Practice address
- 1850 Brighton Henrietta Town Line Road
Rochester, NY 14623 - Phone
- (585) 424-6210
- Fax
- (585) 424-1202
- NPI assigned
- Jun 15, 2006
- Last updated
- Oct 28, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 197323 | NY | Primary |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 197323 | NY |
Addresses
Primary practice location
1850 Brighton Henrietta Town Line Road
Rochester, NY 14623
Mailing address
800 Carter Street
Rochester, NY 14621
Phone (585) 339-4793
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00040452902 | Other | NY | UNIVERA # |
| 0191601 | Other | NY | IHA # |
| 197323-9W | Other | NY | WORKERS COMP # |
| P010197323 | Other | NY | BLUE CHOICE # |
| 101546DL | Other | NY | PREFERRED CARE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197323 | NY | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288224000000",
"number": "1881638740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 CARTER STREET",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14621",
"telephone_number": "585-339-4793",
"fax_number": "585-336-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 BRIGHTON HENRIETTA TOWN LINE ROAD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14623",
"telephone_number": "585-424-6210",
"fax_number": "585-424-1202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASSAMAN",
"first_name": "EDWARD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2010-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "197323",
"primary": true
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "NY",
"license": "197323",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA #",
"identifier": "00040452902",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA #",
"identifier": "0191601",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP #",
"identifier": "197323-9W",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE #",
"identifier": "P010197323",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE #",
"identifier": "101546DL",
"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 Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.