MEDICARE: MS. PATRICIA ANN MCCABE PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	F380023	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01725	OTHER	NY	BLUE SHIELD OF ROCHESTER
2	384748	OTHER	NY	MVP UPSTATE DHP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4334391	OTHER		AETNA US HEALTHCARE
5	RC60164923	OTHER		POMCO
6	Y028938	OTHER		TRICARE REGION 1
7	NP0020	OTHER	NY	PREFERRED CARE

General Provider Information

NPI Number	:	1215012521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN MCCABE PNP

Provider Business Mailing Address
First Line	:	9 LANTERN LN
Second Line	:
City	:	HONEOYE FALLS
State	:	NY
Zip	:	14472-9321
Country	:	US
Telephone Number	:	585-255-0685
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 BUFFALO RD
Second Line	:	SUITE 200 GENESIS PEDIATRICS
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1502
Country	:	US
Telephone Number	:	585-426-4100
Fax Number	:	585-426-3701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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