Individual provider Active NPI

Joseph F Smizzi, PA

  • Physician Assistant
  • Penfield, NY
National Provider Identifier
1912915620
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007341-1 Issued in NY
Practice address
2212 Penfield Rd
Suite 200
Penfield, NY 14526-1756
Phone
(585) 598-8567
Fax
(585) 388-1483
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007341-1 NY Primary

Addresses

Primary practice location

2212 Penfield Rd
Suite 200
Penfield, NY 14526-1756

Mailing address

601 Elmwood Ave
Box 278980
Rochester, NY 14642-0001

Other identifiers 1

IdentifierTypeStateIssuer
02564914MedicaidNY

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
I20051012000773 NY Practitioner - Physician Assistant 0648295204 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007341-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Jan 23, 2012 Accepting new patients
Internal Medicine at Lakeside Past Accepting new patients

Locations

470 Collins St
Avon, NY 14414
Phone (585) 226-2640

2212 Penfield Rd
Ste 200
Penfield, NY 14526
Phone (585) 598-8565

601 Elmwood Ave
#278980
Rochester, NY 14642
Phone (585) 768-2620

601 Elmwood Ave
#320
Rochester, NY 14642

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: josephsmizzi@nslijmedgr.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1912915620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 278980",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 PENFIELD RD",
            "address_2": "SUITE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261756",
            "telephone_number": "585-598-8567",
            "fax_number": "585-388-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIZZI",
        "first_name": "JOSEPH",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007341-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02564914",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.