Individual provider Active NPI

John S. McIntyre, M.D.

  • Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1902832827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
103314 Issued in NY
Practice address
2000 Winton Rd S
Building 4, Suite 303
Rochester, NY 14618-3970
Phone
(585) 473-3730
Fax
(585) 473-3741
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 103314 NY Primary

Addresses

Primary practice location

2000 Winton Rd S
Building 4, Suite 303
Rochester, NY 14618-3970

Mailing address

2000 Winton Rd S
Building 4, Suite 303
Rochester, NY 14618-3970
Phone (585) 473-3730

Other identifiers 1

IdentifierTypeStateIssuer
00454628MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040127000588 NY Practitioner - Psychiatry 9739081928 Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902832827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WINTON RD S",
            "address_2": "BUILDING 4, SUITE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183970",
            "telephone_number": "585-473-3730",
            "fax_number": "585-473-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WINTON RD S",
            "address_2": "BUILDING 4, SUITE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183970",
            "telephone_number": "585-473-3730",
            "fax_number": "585-473-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "JOHN",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "103314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00454628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.