ETHAN NERE BEAUDETT (NPI# 1205240835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205240835 |
| Entity Type | Individual |
| Full Name | ETHAN NERE BEAUDETT |
| Credential | D.O |
| Practice Address |
738 Library Road #1 Rochester NY 14627-0617 |
| Mailing Address |
738 Library Road Po Box 270617 Rochester NY 14627-0617 |
| Practice Telephone | 5852752662 |
| Practice Fax Number | 5852760149 |
| Mailing Telephone | 5852752662 |
| Mailing Fax Number | 5852760149 |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2020-05-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 290946 | NY | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
290946 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
738 LIBRARY ROAD #1 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14627-0617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518116243 | Ronke Lattimore Tapp | Psychologist | 738 Library Road, 3rd Flr University Counseling Center U of Rochester, Rochester, NY 14627-0356 | 2008-09-18 |
| 1881189819 | Megan Murray White | Psychologist | 738 Library Road, 3rd Floor, Rochester, NY 14627 | 2018-06-22 |
| 1467872309 | Kelly Willson | Psychologist | 738 Library Road, Room 325, Rochester, NY 14627-0472 | 2014-04-18 |
| 1619398690 | Arjan Berkeljon | Psychologist | 738 Library Road, Rochester, NY 14627-0356 | 2013-12-18 |
| 1316237613 | Dagmar R Kaufmann | Psychologist | 738 Library Road, University Counseling Center, University of Rochester, Rochester, NY 14627 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578176749 | Harry Campbell | Specialist/Technologist | 500 Joseph C. Wilson Blvd., Rochester, NY 14627 | 2020-08-28 |
| 1992358907 | Audra Stickney | Dietitian, Registered | 783 Library Rd, Rochester, NY 14627 | 2019-07-18 |
| 1447328778 | Shauny Lynn Caruso | Specialist/Technologist | Goergen Athletic Center, University of Rochester, Rochester, NY 14627 | 2006-12-04 |
| 1063583011 | Patricia M. Mallon | Registered Nurse | University Counseling Center, Box 270356, Rochester, NY 14627 | 2006-11-13 |
| 1497795181 | Brigid M Cahill | Psychologist | Towne House 1325 Mt. Hope Ave, University Counseling Center, Rochester, NY 14627 | 2006-06-08 |
| 1578526778 | Angelo Zegarelli | Specialist/Technologist | 1163 Goergen Athletic Center, University of Rochester, Rochester, NY 14627 | 2006-04-10 |
| 1417050741 | Strong Memorial Hospital | General Acute Care Hospital | 601 Elmwood Ave, Rochester, NY 14627 | 2006-09-05 |
| 1801108741 | Orlando Omar Harris | Nurse Practitioner | 500 Joseph C Wilson Blvd, Rochester, NY 14627-0001 | 2010-07-08 |
| 1588952303 | Edward L Deci | Psychologist | 429 Meliora Hall, University of Rochester, Rochester, NY 14627-0266 | 2011-07-13 |
| 1588117550 | Eric Rozen | Specialist/Technologist | 601 Elmwood Avenue, Rochester, NY 14627-0296 | 2016-07-26 |
| Find all providers in zip 14627 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356565790 | Christine Anne Blonski | Family Medicine | 2619 Culver Rd Ste 2a, Rochester, NY 14609-1738 | 2007-04-13 |
| 1023464203 | Scott Joseph Biehl | Family Medicine | 2410 Ridgeway Ave, Rochester, NY 14626-4114 | 2016-05-06 |
| 1871974022 | Mark Cipriani Jr. | Family Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2015-06-13 |
| 1700205846 | Jasper Gill | Family Medicine | 4986 N Adams Rd Ste A, Rochester, MI 48306 | 2014-04-15 |
| 1427207133 | Kate Grant | Family Medicine | 2619 Culver Rd Ste 2a, Rochester, NY 14609-1738 | 2008-09-17 |
| 1710136411 | Daniel D Day | Family Medicine | 2619 Culver Rd, Rochester, NY 14609-1738 | 2008-09-17 |
| 1700822459 | E James Swenson | Family Medicine | 601 Elmwood Ave, Box 665, Rochester, NY 14642-0001 | 2006-06-21 |
| 1154316669 | Nicholas I Kilmer | Family Medicine | 1425 Portland Ave, Rochester, NY 14621-3001 | 2005-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023638012 | Sports Medicine Specialist P.C. | Family Medicine | 1578 Williamsbridge Rd # 3d, Bronx, NY 10461-6265 | 2020-04-20 |
| 1588104855 | Winston Medical PC | Family Medicine | 10814 72nd Ave Ste 4, Forest Hills, NY 11375-5301 | 2017-03-06 |
| 1649680240 | Makoto Michael Yoshino | Family Medicine | 22 W 21st St Ste 400, New York, NY 10010 | 2014-05-05 |
| 1215378369 | Elan Luria Goldwaser | Family Medicine | 1 Pondfield Road, 1st Floor, Bronxville, NY 10708 | 2013-07-17 |
| 1134431554 | Joseph Weber-lopez | Family Medicine | 158 E Main St Ste 3, Huntington, NY 11743-2988 | 2010-07-14 |
| 1881857159 | James Nathan Robinson | Family Medicine | 148-168 39th St, Floor 7, Brooklyn, NY 11232 | 2008-07-08 |
| 1639332422 | Marlon Stephen Mathews | Family Medicine | 184 Losson Road, Cheektowaga, NY 14227 | 2008-07-02 |
| 1598954158 | Anthony Cappellino Md PC | Family Medicine | 60 Fleets Point Dr, Suite 1, West Babylon, NY 11704-8314 | 2007-10-19 |
| 1265505036 | Si Medical Practice Associate PC | Family Medicine | 1147 Richmond Road, Staten Island, NY 10304 | 2006-11-17 |
| 1689769366 | Steven Andre Radi | Family Medicine | 1 College Cir, Geneseo, NY 14454-1401 | 2006-10-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ETHAN NERE BEAUDETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.