Individual provider Active NPI

Mary Reisig, WHNP

  • Obstetrics & Gynecology Physician
  • Rochester, NY
National Provider Identifier
1982648804
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
420578 Issued in NY
Practice address
2255 Clinton Ave S
Rochester, NY 14618-2623
Phone
(585) 473-6301
Fax
(585) 473-6911
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X F420578 NY
Obstetrics & Gynecology Physician 207V00000X 420578 NY Primary

Addresses

Primary practice location

2255 Clinton Ave S
Rochester, NY 14618-2623

Mailing address

601 Elmwood Ave
Box 668
Rochester, NY 14642-0001
Phone (585) 473-6301

Other identifiers 2

IdentifierTypeStateIssuer
02414868MedicaidNY
P00031020OtherNYMEDICARE RR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mreisig111756@direct.urmc.rochester.edu Direct
Direct Messaging Address mreisig111756@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000776 NY Practitioner - Nurse Practitioner 0143123406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Strong Obstetrics-Gynecology GroupGroup PAC ID 2860382926, 79 clinicians

Practice addresses (Care Compare)

2255 S Clinton Ave
Rochester, NY 14618-2623
Phone (585) 271-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
420578NYMDObstetrics & Gynecology Physician
353392NYMDFamily Nurse Practitioner
F420578NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Strong Obstetrics-Gynecology Group Obstetrics & Gynecology CurrentSince Jan 30, 2017 Accepting new patients

Locations

601 Elmwood Ave
#668
Rochester, NY 14642
Phone (585) 275-2691

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

2255 S Clinton Ave
Rochester, NY 14618
Phone (585) 271-7800

Organizations & group practices 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1982648804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 668",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-473-6301",
            "fax_number": "585-473-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182623",
            "telephone_number": "585-473-6301",
            "fax_number": "585-473-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISIG",
        "first_name": "MARY",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F420578",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "420578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02414868",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00031020",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreisig111756@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": "mreisig111756@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": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.