NPIMap

Organization Active NPI

Jewish Family Service of Rochester Inc

  • Adult Development & Aging Psychologist
  • Rochester, NY
National Provider Identifier
1942429527
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
TB100185 Issued in NY
Legal business name
JEWISH FAMILY SERVICE OF ROCHESTER INC
Practice address
255 East Ave Ste 201
Rochester, NY 14604-2626
Phone
(585) 461-0110
NPI assigned
Apr 24, 2007
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Ms. Kristen Lang
Title
Cfo
Phone
(585) 461-0110

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X TB100185 NY
Adult Development & Aging Psychologist 103TA0700X TB100185 NY Primary
Clinical Social Worker 1041C0700X TB100185 NY

Addresses

Primary practice location

255 East Ave Ste 201
Rochester, NY 14604-2626

Mailing address

255 East Ave Ste 201
Rochester, NY 14604-2626
Phone (585) 461-0110

Other identifiers 2

IdentifierTypeStateIssuer
01799384MedicaidNY
02001765MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120718000739 NY Part B Supplier - Clinic/Group Practice 4789840752 Receives reassigned benefits from 4 practitioners
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Tax ID family
Jewish Family Service of Rochester Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

441 East Ave
Rochester, NY 14607
Phone (585) 461-0110

441 East Ave
Ste 3
Rochester, NY 14607
Phone (585) 461-0110

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1942429527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 EAST AVE STE 201",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042626",
            "telephone_number": "585-461-0110",
            "fax_number": "585-461-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EAST AVE STE 201",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042626",
            "telephone_number": "585-461-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY SERVICE OF ROCHESTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-461-0110",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "TB100185",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "TB100185",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "TB100185",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01799384",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02001765",
            "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 Jan 4, 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.