Individual provider Active NPI

Daniel Demilio, P.A.

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1972600161
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005150 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3001
Phone
(585) 922-4000
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005150 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040331000159 NY Practitioner - Physician Assistant 8325030430 Reassigns benefits to 2 organizations
I20201103000973 FL Practitioner - Physician Assistant 8325030430 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005150NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Wayne Community Hospital CurrentSince Apr 25, 2013 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2004 Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Sep 16, 2020 Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Sep 16, 2020 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2004 Accepting new patients
Newark Wayne Community Hospital CurrentSince Apr 25, 2013 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients

Locations

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

16521 US 301 S
Wimauma, FL 33598
Phone (813) 844-4700

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

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

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972600161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMILIO",
        "first_name": "DANIEL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.