Individual provider Active NPI

Samuel Urrutia Fraguada, MD

  • Internal Medicine Physician
  • Geneva, NY
National Provider Identifier
1982280525
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
340961 Issued in NY
Practice address
833 Canandaigua Rd
Geneva, NY 14456-2015
Phone
(315) 787-5155
Fax
(315) 787-5151
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 340961 NY Primary
Internal Medicine Physician 207R00000X MD61526346 WA

Addresses

Primary practice location

833 Canandaigua Rd
Geneva, NY 14456-2015

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 814-2115

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address surrutiafraguada437277@direct.rochesterregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240724001601 WA Practitioner - Internal Medicine 2163828906 Reassigns benefits to 1 organization
I20260112000702 NY Practitioner - Internal Medicine 2163828906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. Internal Medicine CurrentSince Dec 8, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Dec 8, 2025 Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

833 Canandaigua Rd
Geneva, NY 14456
Phone (315) 210-1331

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

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

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Interoperability endpoints

  • Direct secure messaging: surrutiafraguada437277@direct.rochesterregional.org

Organizations & group practices 7

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 1

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1982280525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CANANDAIGUA RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562015",
            "telephone_number": "315-787-5155",
            "fax_number": "315-787-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-814-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URRUTIA FRAGUADA",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "340961",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61526346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "surrutiafraguada437277@direct.rochesterregional.org",
            "affiliation": "N",
            "endpointDescription": "Rochester Regional Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Rochester Regional Health",
            "address_1": "833 Canandaigua Rd",
            "city": "Geneva",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144562015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.