Individual provider Active NPI

Beth M Pannell, PA

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1982876470
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014187 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3011
Phone
(585) 338-1200
Fax
(585) 544-1359
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 014187 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3011

Mailing address

PO Box 14523
Rochester, NY 14614-0523
Phone (585) 613-2084

Other practice location 1

470 Long Pond Rd
Rochester, NY 14612-3057
Phone (585) 338-1200

Other practice location 2

800 Carter St
Rochester, NY 14621-2604
Phone (585) 338-1400

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
I20110120000921 NY Practitioner - Physician Assistant 6406035674 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Apr 1, 2020 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jul 11, 2025 Accepting new patients
Rochester General Hospital Physician Assistant CurrentSince Apr 1, 2020 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Apr 1, 2020 Accepting new patients
Rochester General Hospital CurrentSince Apr 1, 2020 Accepting new patients
Niagara Hospitalist, PC Past Accepting new patients
Physician Mobile Medical Care PC PastSince Apr 1, 2025 Accepting new patients

Locations

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

1425 Portland Ave
Bldg 1
Rochester, NY 14621
Phone (585) 338-1400

2745 W Ridge Rd
Rochester, NY 14626
Phone (585) 225-5252

470 Long Pond Rd
Rochester, NY 14612
Phone (585) 227-7600

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

Interoperability endpoints

  • Direct secure messaging: beth.pannell.1@10568.direct.athenahealth.com

Organizations & group practices 10

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": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1982876470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14523",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146140523",
            "telephone_number": "585-613-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213011",
            "telephone_number": "585-338-1200",
            "fax_number": "585-544-1359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146123057",
            "country_code": "US",
            "telephone_number": "585-338-1200",
            "fax_number": "585-544-1359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Carter St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146212604",
            "country_code": "US",
            "telephone_number": "585-338-1400",
            "fax_number": "585-339-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "BETH",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.