DR. ELISE W VAN DER JAGT MD
NPI 1083650949
Pediatrics - Pediatric Critical Care Medicine in Rochester, NY

Q: What is Elise Van Der Jagt's NPI number?

The NPI number for Elise Van Der Jagt is 1083650949. It was assigned to this individual provider in the NPPES registry on June 21, 2006.

Q: What is Elise Van Der Jagt's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Active since June 21, 2006PECOS Enrolled

601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642(585) 275-8138(585) 275-2352 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

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About Dr. Elise W Van Der Jagt Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELISE W VAN DER JAGT MD (NPI 1083650949) is an individual pediatric critical care medicine provider in Rochester, New York, licensed in New York (124938) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083650949

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameDR. ELISE W VAN DER JAGTCredential: MD

Location Address601 ELMWOOD AVE, BOX 635Rochester, NY 14642-0001

Mailing Address601 Elmwood Ave, Box 635Rochester, NY 14642-0001 · (585) 275-8138 · Fax (585) 275-2352

Phone(585) 275-8138

Fax(585) 275-2352

Sole ProprietorNo

Enumeration DateJune 21, 2006

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

✔ NPI 1083650949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in NY · 124938

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedPediatricsTaxonomy 208000000X · License 124938 (NY)

601 ELMWOOD AVE, Rochester, NY 14642

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Other Identifiers 1

Medicaid00512863NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Elise W Van Der Jagt Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Elise Van Der Jagt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pediatric Allergy Of Pulmonary

0.1 mi

Pediatric Pulmonology

601 ELMWOOD AVE, BOX 635
Rochester, NY 14642

Reassigned Medicare billing, New York enrollment
61 clinicians in this Medicare group

NPI 1013952688 (585) 275-7787

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARIE E BRADT RPA-C

Physician Assistant

601 ELMWOOD AVE
ROCHESTER, NY 14642

Monroe County (585) 275-6070

DR. RITA DADIZ DO

Pediatrics (Neonatal-Perinatal Medicine)

601 ELMWOOD AVE, BOX 635
ROCHESTER, NY 14642

Monroe County (585) 275-7787

DR. SCOTT ROSS SCHIFFMAN M.D.

Radiology (Diagnostic Radiology)

601 ELMWOOD AVE, BOX 648
ROCHESTER, NY 14642

Monroe County (585) 275-1128

SARAH ANNE ROSSI FNP

Nurse Practitioner (Family)

601 ELMWOOD AVE, BOX 652
ROCHESTER, NY 14642

Monroe County (585) 279-5100

JIMENA CUBILLOS MD

Urology (Pediatric Urology)

601 ELMWOOD AVE, BOX 656
ROCHESTER, NY 14642

Monroe County (585) 275-3342

MRS. ANNE SCHERBERGER KEEFER RN NP

Nurse Practitioner (Adult Health)

601 ELMWOOD AVE, BOX 704
ROCHESTER, NY 14642

Monroe County (585) 275-5307

SCOTT OVERHOLT DDS

Student in an Organized Health Care Education/Training Program

601 ELMWOOD AVE, BOX 705
ROCHESTER, NY 14642

Monroe County (585) 275-7978

MS. SARAH L AVERILL MD

Radiology (Diagnostic Radiology)

601 ELMWOOD AVE
ROCHESTER, NY 14642

Monroe County (585) 275-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elise Van Der Jagt's NPI number?

The NPI number for Elise Van Der Jagt is 1083650949. It was assigned to this individual provider in the NPPES registry on June 21, 2006.

Where is Elise Van Der Jagt located?

Elise Van Der Jagt practices at 601 Elmwood Ave Box 635, Rochester, NY 14642. The listed phone number is (585) 275-8138.

What is Elise Van Der Jagt's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Elise Van Der Jagt enrolled in Medicare?

Yes. Elise Van Der Jagt is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elise Van Der Jagt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elise Van Der Jagt reassigns Medicare benefits to Pediatric Allergy Of Pulmonary (Rochester, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Elise Van Der Jagt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Elise Van Der Jagt was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.