Jill A Abt, MD
Individual provider Active NPI Pediatrics Physician · Rochester, NY
NPI 1891223673 · NPPES record last updated Dec 2, 2021
Key facts
- NPI
- 1891223673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 1490778 (NY)
- Practice address
- 1555 Long Pond Rd
Rochester, NY 14626-4164 - Phone
- (585) 368-4020
- NPI assigned
- May 24, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220106000454 | NY | Practitioner - Pediatric Medicine | 2062786049 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311266 | NY | MD | Licensed Practical Nurse |
| 271635 | MA | MD | Pediatrics Physician |
| 1490778 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Unity Hospital of Rochester | Current |
Accepting new patients | |
| The Unity Hospital of Rochester | Current | Accepting new patients | |
| Rochester General Hospital | Past | Accepting new patients |
Locations
1800 English Rd
Ste 10
Rochester, NY 14616
Phone (585) 225-2525
100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553
1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289
Interoperability endpoints
- jillabtmd@erpam.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 271635 | MA | |
| Pediatrics Physician | 208000000X | 1490778 | NY | Yes |
Addresses
Primary practice location
1555 Long Pond Rd
Rochester, NY 14626-4164
Mailing address
347 Rutgers Street
Rochester, NY 14607
Phone (617) 875-5065
Other practice location 1
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2000
Other practice location 2
295 Varnum Ave
Lowell, MA 01854-2193
Phone (978) 937-6000
Other names
- Jill A Kulla
Other providers in Rochester, NY
- Frank S. Abreau
- Jonathan Abres
- Ricardo Teixeira Abreu
- Vanessa Lynn Abreu
- Rebecca Abrey
- Patrick Abt
- Farhad Abtahian
- Asim Mohammed Abu-Baker
- Zahir Abu-Baker
- Brenda Ariba Zarhari Abu
All providers in Rochester, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.