Individual provider Active NPI

Jennifer N Tantalo, RPA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1942279666
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010361 Issued in NY
Practice address
500 Helendale Road
Suite 100
Rochester, NY 14609
Phone
(585) 266-5420
Fax
(585) 266-5423
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 010361 NY Primary

Addresses

Primary practice location

500 Helendale Road
Suite 100
Rochester, NY 14609

Mailing address

500 Helendale Road
Suite 100
Rochester, NY 14609
Phone (585) 266-5420

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
I20050513000553 NY Practitioner - Physician Assistant 3375584923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greece Dermatological Associates PCGroup PAC ID 3678581394, 8 clinicians
Rochester Dermatologic Surgery PCGroup PAC ID 8729315080, 6 clinicians

Practice addresses (Care Compare)

120 Erie Canal Dr
Suite 200
Rochester, NY 14626-4609
Phone (585) 719-9600

7400 Pittsford Victor Rd
Victor, NY 14564-9725
Phone (585) 222-1400

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
78.47 of 100Reported as group
Quality
40.73
Promoting interoperability
94
Improvement activities
40
Cost
92.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010361NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Greece Dermatological Associates, PC CurrentSince Feb 2, 2026 Accepting new patients
Rochester General Hospital Past Accepting new patients
Victor Dermatology PC PastSince Mar 13, 2022 Accepting new patients

Locations

730 Weiland Rd
Rochester, NY 14626
Phone (585) 719-9600

120 Erie Canal Dr
Ste 200
Rochester, NY 14626
Phone (585) 225-6680

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1942279666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HELENDALE ROAD",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14609",
            "telephone_number": "585-266-5420",
            "fax_number": "585-266-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HELENDALE ROAD",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14609",
            "telephone_number": "585-266-5420",
            "fax_number": "585-266-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTALO",
        "first_name": "JENNIFER",
        "middle_name": "N",
        "name_prefix": "Miss",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.