LATTIMORE PRIMARY CARE MEDICINE, PLLC (NPI# 1730421272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730421272 |
| Entity Type | Organization |
| Organization Name | LATTIMORE PRIMARY CARE MEDICINE, PLLC |
| Practice Address |
560 White Spruce Blvd Rochester NY 14623-1613 |
| Practice Telephone | 5852715250 |
| Practice Fax Number | 5852710129 |
| Mailing Telephone | 5852715250 |
| Mailing Fax Number | 5852710129 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |
| Authorized Official Name | DR. RUSSELL P MAGGIO (OWNER) |
| Authorized Official Telephone | 5852715250 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 161925 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EXCELLUS | 1392 | 01 |
| NY | MVP | MD198C | 01 |
| Street Address |
560 WHITE SPRUCE BLVD |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14623-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972916799 | Kelly Jo Gursslin | Nurse Practitioner | 560 White Spruce Blvd, Rochester, NY 14623-1613 | 2014-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235637141 | Cornerstone Dental of Henrietta | Dentist | 2104 E. Henrietta Road, Rochester, NY 14623 | 2018-01-25 |
| 1770019713 | Brenna Cavanaugh | Psychologist | 200 East River Rd., Rochester, NY 14623 | 2017-05-11 |
| 1932649522 | Annette F. Cranker | Registered Nurse | 100 Groton Parkway, Rochester, NY 14623 | 2017-03-01 |
| 1588049258 | Lisa Parnell | Nurse Practitioner | 200 East River Road, Rochester, NY 14623 | 2015-07-23 |
| 1811371610 | Deanna Phoenix | Pharmacist | Elm & Carlton Streets, Main Hospital, Roswell Park Cancer Institute, Buffalo, NY 14623 | 2015-07-13 |
| 1518340801 | Erin Wong | Counselor | 945 E. Henrietta Rd, Suite 7a, Rochester, NY 14623 | 2015-07-04 |
| 1427437490 | Sarah Beren | Counselor | 115 Metro Park, Rochester, NY 14623 | 2015-05-23 |
| 1346628930 | Bohdan Klymochko | Family Medicine | 1300 Jefferson Rd Ste 100, Rochester, NY 14623 | 2015-05-14 |
| 1306242763 | Rochester Institute of Technology | Psychiatric Unit | 1 Lomb Memorial Drive, Rochester, NY 14623 | 2014-11-13 |
| 1972904423 | Jonathan Bloom | Urology | 400 White Spruce Blvd Ste B, Rochester, NY 14623 | 2014-09-15 |
| Find all providers in zip 14623 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326694225 | Henry John James Ess Iv Do Pllc | Internal Medicine | 309 Exchange Blvd Ste A, Rochester, NY 14608-2708 | 2019-08-15 |
| 1588180087 | Shelby Jo Lee | Internal Medicine | 2561 Lac De Ville Blvd Ste 100, Rochester, NY 14618-5645 | 2017-08-16 |
| 1598294704 | Ayad Sadda | Internal Medicine | 1425 Portland Ave Ste 287, Rochester, NY 14621-3011 | 2017-06-09 |
| 1184150567 | Kayla Leonard Correia-staudt | Internal Medicine | 959 Panorama Trl S Ste 100, Rochester, NY 14625-2311 | 2017-05-04 |
| 1912438342 | William J. Brorein, Jr., M.d., Ph.d. | Internal Medicine | 2237 Clinton Ave S, Rochester, NY 14618-2623 | 2017-03-27 |
| 1871944520 | Kayleigh Punch | Internal Medicine | 2655 Ridgeway Ave Ste 480, Rochester, NY 14626-4296 | 2016-06-23 |
| 1003260837 | Natalia Golub | Internal Medicine | 30 Hagen Dr Ste 320, Rochester, NY 14625 | 2016-04-18 |
| 1699161018 | Gregory Rosic | Internal Medicine | 6 Healthcare Dr Ste 2, Rochester, NH 03867-4499 | 2015-04-13 |
| 1437543097 | Kathleen Skye Kemp | Internal Medicine | 2400 S Clinton Ave Ste G2, Rochester, NY 14618 | 2015-03-22 |
| 1386086957 | Robert M Kerper Md, Pllc | Internal Medicine | 26 South Goodman Street, Rochester, NY 14607 | 2013-07-24 |
| Find all providers in ROCHESTER | ||||
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| 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.