Individual provider Active NPI

Myra L. Mathis-Uwanogho, MD

  • Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1962881128
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
304885 Issued in NY
Practice address
300 Crittenden Blvd
Rochester, NY 14642-3108
Phone
(585) 275-4501
NPI assigned
May 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 304885 NY
Psychiatry Physician 2084P0800X 304885 NY Primary

Addresses

Primary practice location

300 Crittenden Blvd
Rochester, NY 14642-3108

Mailing address

300 Crittenden Blvd Box Psych
Rochester, NY 14642-0001
Phone (585) 275-8375

Other names 1

  • Myra L Mathis Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmathis74815@direct.urmc.rochester.edu Direct
Direct Messaging Address mmathis74815@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727000893 NY Practitioner - PsychiatryPractitioner - Addiction Medicine 6800101668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of Rochester School of Medicine and Dentistry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2613 W Henrietta Rd
Rochester, NY 14623-2327
Phone (585) 279-4900

2617 W Henrietta Rd
Rochester, NY 14623-2327
Phone (585) 276-7620

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

Hospital & facility affiliations

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Aug 1, 2020 Accepting new patients
University of Rochester Psychiatry CurrentSince Aug 1, 2020 Accepting new patients
University of Rochester Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients

Locations

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

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

Interoperability endpoints

  • Direct secure messaging: mmathis74815@direct.urmc.rochester.edu

Organizations & group practices 5

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": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1962881128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD BOX PSYCH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146423108",
            "telephone_number": "585-275-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS-UWANOGHO",
        "first_name": "MYRA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2023-07-03",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "304885",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "304885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmathis74815@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": "mmathis74815@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": [
        {
            "first_name": "MYRA",
            "last_name": "MATHIS",
            "middle_name": "L",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.