NPIMap

Organization Active NPI

Breast Cancer Surgery of the University of Rochester

  • Surgical Oncology Physician
  • Rochester, NY
National Provider Identifier
1932357795
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
Legal business name
BREAST CANCER SURGERY OF THE UNIVERSITY OF ROCHESTER
Practice address
601 Elmwood Ave
Rochester, NY 14642-0002
Phone
(585) 341-0366
NPI assigned
Sep 5, 2008
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Jill M Hetterich
Title
Senior Director of Finance Urmfg
Phone
(585) 756-4008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086X0206X Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0002

Mailing address

601 Elmwood Ave Box Surg
Rochester, NY 14642-0001
Phone (585) 341-0366

Other identifiers 2

IdentifierTypeStateIssuer
03130816MedicaidNY
DP9770OtherNYMEDICARE RAILROAD PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090114000439 NY Part B Supplier - Clinic/Group Practice 0446313621 Receives reassigned benefits from 24 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

995 Senator Keating Blvd
Ste 205
Rochester, NY 14618
Phone (585) 276-3332

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1932357795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX SURG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-341-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420002",
            "telephone_number": "585-341-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAST CANCER SURGERY OF THE UNIVERSITY OF ROCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "HETTERICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF FINANCE URMFG",
        "authorized_official_telephone_number": "585-756-4008"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03130816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "DP9770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 10, 2022; 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.