NPIMap

Organization Active NPI

Western New York Medical Practice, P.C.

  • Ophthalmology Physician
  • Rochester, NY
National Provider Identifier
1891467486
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WESTERN NEW YORK MEDICAL PRACTICE, P.C.
Practice address
2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Phone
(585) 244-0332
NPI assigned
Oct 1, 2021
Organization subpart
Yes
Parent organization
WESTERN NEW YORK MEDICAL PRACTICE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Nichole S Holder
Title
Director - Payer Enrollment
Phone
(585) 922-0293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2301 Lac de Ville Blvd
Rochester, NY 14618-5646

Mailing address

2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Phone (585) 244-0332

Other practice location 1

10 S Pointe Lndg
Rochester, NY 14606-3481
Phone (585) 244-0332

Other names 1

  • Rochester Regional Health Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111110000598 NY Part B Supplier - Clinic/Group Practice 3870767791 Receives reassigned benefits from 1,353 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Western New York Medical Practice PC13 organizations share this tax ID, including this one
Part of
Western New York Medical Practice PC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1065 Senator Keating Blvd
Rochester, NY 14618
Phone (585) 256-1330

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 71

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1891467486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 S Pointe Lndg",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146063481",
            "country_code": "US",
            "telephone_number": "585-244-0332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WESTERN NEW YORK MEDICAL PRACTICE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN NEW YORK MEDICAL PRACTICE, P.C.",
        "enumeration_date": "2021-10-01",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR - PAYER ENROLLMENT",
        "authorized_official_telephone_number": "585-922-0293"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rochester Regional Health Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.