Individual provider Active NPI

Joseph Raymond Duba, MD

  • General Practice Physician
  • Shortsville, NY
National Provider Identifier
1942389689
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1384541 Issued in NY
Practice address
8 West Main Street
Shortsville, NY 14548
Phone
(585) 289-9160
Fax
(585) 289-9162
NPI assigned
Nov 3, 2006
Last updated
Dec 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 1384541 NY Primary

Addresses

Primary practice location

8 West Main Street
Shortsville, NY 14548

Mailing address

PO Box 8
8 West Main Street
Shortsville, NY 14548
Phone (585) 289-9160

Other identifiers 1

IdentifierTypeStateIssuer
00941488MedicaidNY

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
I20040216000350 NY Practitioner - General Practice 9931094463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Chicago, Pritzker School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560

3170 W St
Canandaigua, NY 14424-1712
Phone (585) 396-6990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1384541NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Sep 22, 2014 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Sep 22, 2014 Accepting new patients

Locations

73 Buffalo St
Ste 100
Canandaigua, NY 14424

350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000

3170 West St
Ste 100
Canandaigua, NY 14424
Phone (585) 396-6990

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

Interoperability endpoints

  • Direct secure messaging: jduba83100@direct.urmc.rochester.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1942389689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "address_2": "8 WEST MAIN STREET",
            "city": "SHORTSVILLE",
            "state": "NY",
            "postal_code": "14548",
            "telephone_number": "585-289-9160",
            "fax_number": "585-289-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WEST MAIN STREET",
            "city": "SHORTSVILLE",
            "state": "NY",
            "postal_code": "14548",
            "telephone_number": "585-289-9160",
            "fax_number": "585-289-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBA",
        "first_name": "JOSEPH",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "1384541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00941488",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shortsville, NY

Sources for this page

Verify at the official NPI Registry.