Individual provider Active NPI

Bethany Jovkovski, NP

  • Pediatric Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1922660497
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382980 Issued in NY
Practice address
961 Panorama TRL S Ste 1
Rochester, NY 14625-2311
Phone
(585) 381-4848
Fax
(585) 641-2205
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382980 NY Primary

Addresses

Primary practice location

961 Panorama TRL S Ste 1
Rochester, NY 14625-2311

Mailing address

961 Panorama TRL S Ste 1
Rochester, NY 14625-2311
Phone (585) 381-4848

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bdakin96876@direct.urmc.rochester.edu Direct
Direct Messaging Address bdakin96876@direct.urmc.rochester.edu Direct

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
I20190917002880 NY Practitioner - Nurse Practitioner 0143559138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Group Univ of Rochester CurrentSince Jul 23, 2019 Accepting new patients
Pediatric Group Univ of Rochester CurrentSince Jul 23, 2019 Accepting new patients
Panorama Pediatric Group, RLLP PastSince Dec 15, 2024 Accepting new patients

Locations

601 Elmwood Ave
#320
Rochester, NY 14642

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

601 Elmwood Ave
#777
Rochester, NY 14642
Phone (585) 275-0995

Interoperability endpoints

  • Direct secure messaging: bdakin96876@direct.urmc.rochester.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1922660497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 PANORAMA TRL S STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252311",
            "telephone_number": "585-381-4848",
            "fax_number": "585-641-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 PANORAMA TRL S STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146252311",
            "telephone_number": "585-381-4848",
            "fax_number": "585-641-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVKOVSKI",
        "first_name": "BETHANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdakin96876@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdakin96876@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.