1. Home
  2. Directory
  3. New York
  4. Rochester
  5. Specialist
  6. NPI Profile

IRONDEQUOIT INTERNAL MEDICINE
NPI 1245375708
Specialist in Rochester, NY

Active since February 21, 2007CLIA 33D0973243 · Waiver
485 TITUS AVE STE H, ROCHESTER, NY 14617(585) 338-2530(585) 338-7304 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Irondequoit Internal Medicine NPPES

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

IRONDEQUOIT INTERNAL MEDICINE (NPI 1245375708) is a healthcare organization registered as a specialist in Rochester, New York and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Larisa Khishchenko, Owner, as its authorized official.

NPPES Registry Identity

NPI1245375708
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameIRONDEQUOIT INTERNAL MEDICINE
Location Address485 TITUS AVE STE HRochester, NY 14617-3544
Mailing Address485 Titus Ave Ste HRochester, NY 14617-3544 · (585) 338-2530 · Fax (585) 338-7304
Phone(585) 338-2530
Fax(585) 338-7304
Organization SubpartNo
Authorized OfficialLarisa KhishchenkoOwner · (585) 338-2530
Enumeration DateFebruary 21, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1245375708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 180528
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
485 TITUS AVE STE H, Rochester, NY 14617
Open in Google Maps ↗

Other Identifiers 2

Medicaid01584647NY
Other102621BJNY · Preferred Care

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0973243

Irondequoit Internal Medicine LLC · Rochester, NY
Active · expires Apr 30, 2028
CLIA Number33D0973243
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorLarisa Khishchenko
Laboratory Phone(585) 338-2530
Laboratory LocationIrondequoit Internal Medicine LLC485 Titus Avenue, Suite H, Rochester, NY 14617
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JEFFREY A LIBERMAN DO PC
Internal Medicine
485 TITUS AVE STE H
ROCHESTER, NY 14617
Monroe County (585) 544-5368

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 Irondequoit Internal Medicine's NPI number?

The NPI number for Irondequoit Internal Medicine is 1245375708. It was assigned to this organization in the NPPES registry on February 21, 2007.

Where is Irondequoit Internal Medicine located?

Irondequoit Internal Medicine is located at 485 Titus Ave Ste H, Rochester, NY 14617. The listed phone number is (585) 338-2530.

What is Irondequoit Internal Medicine's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Irondequoit Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0973243) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Irondequoit Internal Medicine was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.