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JUSTIN T COLE MD
NPI 1306306162
Otolaryngology in Rochester, NY

Active since March 20, 2019PECOS EnrolledAccepts Medicare Assignment
601 ELMWOOD AVE, ROCHESTER, NY 14642(585) 276-5181 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 13, 2024, Mar 20, 2019 (2 updates tracked since 2019).

About Justin T Cole Md NPPES

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

JUSTIN T COLE MD (NPI 1306306162) is an individual otolaryngology provider in Rochester, New York, licensed in Ohio (35.151187) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Southwest General Health Center, and is a graduate of New York Medical College (2019).

NPPES Registry Identity

NPI1306306162
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameJUSTIN T COLECredential: MD
Location Address601 ELMWOOD AVERochester, NY 14642-0001
Mailing Address3049 Stonebrooke LnMedina, OH 44256-5308
Phone(585) 276-5181
Sole ProprietorNo
Medical School CMSNew York Medical CollegeGraduated 2019
Enumeration DateMarch 20, 2019
Last NPPES UpdateAugust 13, 20242 updates tracked since enumeration
NPPES CertifiedAugust 13, 2024
✔ NPI 1306306162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in OH · 35.151187
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
601 ELMWOOD AVE, Rochester, NY 14642
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin T Cole Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032520416
PECOS Enrollment IDI20241007000916
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 Justin Cole reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southwest General Medical Group, Inc.
245 mi
Orthopaedic Surgery
15900 SNOW RD
Brook Park, OH 44142
  • Reassigned Medicare billing, Ohio enrollment
  • 283 clinicians in this Medicare group
NPI 1144414871 (216) 676-1234

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
38 services38 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
37 services36 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
28 services26 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
18 services18 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southwest General Health Center

Acute Care Hospitals · Middleburg Heights, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360155
Location18697 Bagley RoadMiddleburg Heights, OH 44130 · Cuyahoga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14642 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Justin Cole's NPI number?

The NPI number for Justin Cole is 1306306162. It was assigned to this individual provider in the NPPES registry on March 20, 2019.

Where is Justin Cole located?

Justin Cole practices at 601 Elmwood Ave, Rochester, NY 14642. The listed phone number is (585) 276-5181.

What is Justin Cole's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Justin Cole enrolled in Medicare?

Yes. Justin Cole is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Justin Cole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Cole reassigns Medicare benefits to Southwest General Medical Group, Inc. (Brook Park, OH). 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 Justin Cole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Cole accept?

Health plans from Anthem Blue Cross and Blue Shield and MedMutual list Justin Cole 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.

Is Justin Cole affiliated with any hospitals?

According to CMS data, Justin Cole is affiliated with Southwest General Health Center.

When was this NPI record last updated?

The NPPES record for Justin Cole was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.