PEDIATRICS & ADOLESCENT MEDICINE GROUP
NPI 1104861772
Pediatrics - Adolescent Medicine in Rochester, NY
About Pediatrics & Adolescent Medicine Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEDIATRICS & ADOLESCENT MEDICINE GROUP (NPI 1104861772) is a healthcare organization registered as an adolescent medicine in Rochester, New York and active in the NPI registry since June 2006. The organization lists Jill M Hetterich, Senior Director Of Finance Urmfg, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pediatrics & Adolescent Medicine Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to Pediatrics & Adolescent Medicine Group, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 22 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 22Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Pediatrics & Adolescent Medicine Group's NPI number?
The NPI number for Pediatrics & Adolescent Medicine Group is 1104861772. It was assigned to this organization in the NPPES registry on June 18, 2006.
Where is Pediatrics & Adolescent Medicine Group located?
Pediatrics & Adolescent Medicine Group is located at 601 Elmwood Ave Box 635, Rochester, NY 14642. The listed phone number is (585) 275-7787.
What is Pediatrics & Adolescent Medicine Group's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.
Is Pediatrics & Adolescent Medicine Group enrolled in Medicare?
Yes. Pediatrics & Adolescent Medicine Group is registered in the Medicare PECOS enrollment system.
When is Pediatrics & Adolescent Medicine Group's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Pediatrics & Adolescent Medicine Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 7 Medicare specialties reassign their Medicare billing to Pediatrics & Adolescent Medicine Group. A 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 the clinician's services. The largest specialties are Pediatric Medicine (11), Nurse Practitioner (5) and Psychiatry (2). Of these, 12 practice at this address and 22 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Pediatrics & Adolescent Medicine Group accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Pediatrics & Adolescent Medicine Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Pediatrics & Adolescent Medicine Group was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Pediatrics & Adolescent Medicine Group · NPI 1104861772
Adolescent Medicine organization in Rochester, New York. Organization record, active in the CMS NPPES registry since June 18, 2006.
## Identity
- **NPI:** 1104861772 (Entity type: Organization)
- **Enumerated:** June 18, 2006
- **Primary specialty:** Pediatrics - Adolescent Medicine · taxonomy 2080A0000X
- **Organization subpart:** No
- **Authorized official:** Jill Hetterich, SENIOR DIRECTOR OF FINANCE URMFG
## Practice location
- **Address:** 601 ELMWOOD AVE, BOX 635, Rochester, NY 14642-0001
- **Phone:** (585) 275-7787 · **Fax:** (585) 275-2352
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 22 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Pediatric Medicine (11), Nurse Practitioner (5), Psychiatry (2); 12 practice at this address and 22 within 10 miles; [full list](https://npiprofile.com/npi/1104861772/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 28, 2025
- **Other identifiers:** Medicaid 00485887 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1104861772) · Data from the CMS NPPES public registry.