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SOUTHEAST OB-GYN PC
NPI 1184764524
Obstetrics & Gynecology in Rochester, NY

Active since February 07, 2007
990 SOUTH AVE, SUITE 104, ROCHESTER, NY 14620(585) 256-3000(585) 256-3045 Get Directions Write a Review

NPPES record last updated: January 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southeast Ob-gyn Pc NPPES

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

SOUTHEAST OB-GYN PC (NPI 1184764524), doing business as Southeast Obstetrics & Gynecology Pc, is a healthcare organization registered as an obstetrics & gynecology in Rochester, New York and active in the NPI registry since February 2007. The organization lists Katrina Foster, President, as its authorized official.

NPPES Registry Identity

NPI1184764524
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameSOUTHEAST OB-GYN PC
Location Address990 SOUTH AVE, SUITE 104Rochester, NY 14620-2740
Mailing Address990 South Ave, Suite 104Rochester, NY 14620 · (585) 256-3000
Phone(585) 256-3000
Fax(585) 256-3045
Organization SubpartNo
Authorized OfficialKatrina FosterPresident · (585) 256-3000
Enumeration DateFebruary 7, 2007
Last NPPES UpdateJanuary 2, 2026
NPPES CertifiedJanuary 2, 2026
✔ NPI 1184764524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
990 SOUTH AVE, Rochester, NY 14620
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Other Names 1

Doing Business AsSoutheast Obstetrics & Gynecology Pc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeast Ob-gyn Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Southeast Ob-Gyn PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Emily Hart, DO
Obstetrics/Gynecology
NPI 1679193239
990 SOUTH AVE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOS✔ Accepts MedicareSame address
Sarah Nolder, FNP-C
Nurse Practitioner
NPI 1861133746
990 SOUTH AVENUE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOS✔ Accepts MedicareSame address
Amanda Victory, MD
Obstetrics/Gynecology
NPI 1336359777
990 SOUTH AVE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOS✔ Accepts MedicareSame address
Rita Clement, MD
Obstetrics/Gynecology
NPI 1508834201
990 SOUTH AVENUE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOS✔ Accepts MedicareSame address
Raphael Tshibangu, MD
Obstetrics/Gynecology
NPI 1518935378
990 SOUTH AVENUE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOSSame address
Katina Foster, MD
Obstetrics/Gynecology
NPI 1033408810
990 SOUTH AVE SUITE 104
Rochester, NY 14620
(585) 256-3000
✔ PECOS✔ Accepts MedicareSame address

Source: 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 Southeast Ob-Gyn PC's NPI number?

The NPI number for Southeast Ob-Gyn PC is 1184764524. It was assigned to this organization in the NPPES registry on February 7, 2007. The provider is doing business as Southeast Obstetrics & Gynecology PC.

Where is Southeast Ob-Gyn PC located?

Southeast Ob-Gyn PC is located at 990 South Ave Suite 104, Rochester, NY 14620. The listed phone number is (585) 256-3000.

What is Southeast Ob-Gyn PC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Southeast Ob-Gyn PC enrolled in Medicare?

Yes. Southeast Ob-Gyn PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southeast Ob-Gyn PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Southeast Ob-Gyn PC. 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 Obstetrics/Gynecology (5) and Nurse Practitioner (1). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southeast Ob-Gyn PC was last updated on January 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.