DR. SHRUTI DATTA (NPI# 1366643090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366643090 |
| Entity Type | Individual |
| Full Name | DR. SHRUTI DATTA |
| Credential | M.D. |
| Practice Address |
1415 Portland Ave Rochester NY 14621-3038 |
| Practice Telephone | 5859220393 |
| Practice Fax Number | 5859220395 |
| Mailing Telephone | 5859220393 |
| Mailing Fax Number | 5859220395 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 255593 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
255593 | NY | Allopathic & Osteopathic Physicians |
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
55592 | MN | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
106218 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03299878 | 05 | |
| MN | ENROLLED | 05 | |
| IA | ENROLLED | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740331982 | Shruti Datta | Chiropractor | 8371 116th St, Suite M2, Richmond Hill, NY 11418-3448 | 2007-01-15 |
| Street Address |
1415 PORTLAND AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14621-3038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902808223 | Scott L Schabel | Internal Medicine | 1415 Portland Ave, Suite 200, Rochester, NY 14621-3038 | 2005-06-01 |
| 1063055507 | Denetra Morris | Social Worker | 1415 Portland Ave, Rochester, NY 14621-3038 | 2019-10-28 |
| 1518423052 | Jillian Elizabeth Foster | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2019-02-20 |
| 1184109084 | Melissa Podkulski | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2018-09-27 |
| 1689129686 | Claire Helene Smith | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-08-19 |
| 1255885281 | Rachel Houghtling | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-08-08 |
| 1467812214 | Laura Koenig | Nurse Practitioner | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-03-07 |
| 1972972016 | Lauren Eva Hall | Physician Assistant | 1415 Portland Ave, Suite 350, Rochester, NY 14621-3043 | 2015-09-18 |
| 1457758377 | Kristin Rose Henchenski | Physician Assistant | 1415 Portland Ave, Suite 225, Rochester, NY 14621-3039 | 2014-11-20 |
| 1083011076 | Larissa Chapkovich | Dietitian, Registered | 1415 Portland Ave, Rochester, NY 14621-3038 | 2014-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515327 | Patti Humphrey | Occupational Therapist | 1831 Ridge Rd. East, Rochester, NY 14621 | 2019-12-12 |
| 1861956682 | Sonya Thomas | Counselor | Sonya Thomas, 490 East Ridge Road, Rochester, NY 14621 | 2019-01-25 |
| 1811478357 | Laura Iannella | Student in an Organized Health Care Education/Training Program | 1455 East Ridge, Rochester, NY 14621 | 2018-08-23 |
| 1982180345 | Naman Sharma | Student in an Organized Health Care Education/Training Program | Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621 | 2018-07-18 |
| 1699213447 | Kara Mcallister | Nurse Practitioner | 370 East Ridge Road, Suite 400, Rochester, NY 14621 | 2017-02-01 |
| 1285082982 | Universal Care Services, LLC | In Home Supportive Care | 64 Delamaine Drive, Rochester, NY 14621 | 2016-06-03 |
| 1700243896 | Kenroy King I | Registered Nurse | 67 Warsaw Street, Rochester, NY 14621 | 2016-01-21 |
| 1154794808 | Shari Venisee | Licensed Practical Nurse | 67 Carthage St, Rochester, NY 14621 | 2015-11-03 |
| 1114349024 | Anthony Michael Plavsity | Registered Nurse | 1450 Clifford Ave, Rochester, NY 14621 | 2014-01-11 |
| 1033541107 | The Community Place of Greater Rochester, Inc | Case Management | 500 Carter Street, Rochester, NY 14621 | 2013-07-31 |
| Find all providers in zip 14621 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1164853891 | Sukhminder Kaur Sahansra | Internal Medicine | 335 North Park Drive, Elderone, Rochester, NY 14609 | 2013-12-05 |
| 1306058433 | Internal Medicine On East Ridge, LLC | Internal Medicine | 1880 East Ridge Road, Suite 5, Rochester, NY 14622 | 2007-05-03 |
| 1083628838 | Anne M Olinger | Internal Medicine | 2021 Winton Rd S., Jewish Home of Rochester, Rochester, NY 14618 | 2006-07-28 |
| 1720049893 | Partners In Internal Medicine, LLP | Internal Medicine | 30 Hagen Dr., Suite 310, Rochester, NY 14625-1695 | 2006-03-29 |
| 1922068840 | Brenda Jean Iannucci | Internal Medicine | 1880 Ridge Rd E, Suite 5, Rochester, NY 14622-2473 | 2006-03-24 |
| 1558364844 | G. Allen Power | Internal Medicine | St John's Home, 150 Highland Avenue, Rochester, NY 14620 | 2005-05-31 |
| 1558364851 | Marie Aydelotte | Internal Medicine | 2021 Winton Rd S, Rochester, NY 14618-3957 | 2005-05-31 |
| 1003426222 | Hanan Ibrahim Sheikh Ibrahim | Internal Medicine | 1415 Portland Ave Ste 200, Rochester, NY 14621-3022 | 2020-08-03 |
| 1750812244 | Wesley Godfrey | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-03-25 |
| 1881145647 | Ali Ahmad | Internal Medicine | 200 1st St Sw, Rochester, MN 55905 | 2016-10-17 |
| 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.