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EVERGREEN FAMILY MEDICINE, PC
NPI 1528164936
Family Medicine in Brockport, NY

Active since September 15, 2006
4079 LAKE RD N, BROCKPORT, NY 14420(585) 637-0151(585) 637-0562 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evergreen Family Medicine, Pc NPPES

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

EVERGREEN FAMILY MEDICINE, PC (NPI 1528164936) is a healthcare organization registered as a family medicine in Brockport, New York and active in the NPI registry since September 2006. The organization lists David Michael Newman, President, as its authorized official.

NPPES Registry Identity

NPI1528164936
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEVERGREEN FAMILY MEDICINE, PC
Location Address4079 LAKE RD NBrockport, NY 14420-1517
Mailing Address4079 Lake Rd NBrockport, NY 14420-1517 · (585) 637-0151 · Fax (585) 637-0562
Phone(585) 637-0151
Fax(585) 637-0562
Organization SubpartNo
Authorized OfficialDavid Michael NewmanPresident · (585) 637-0151
Enumeration DateSeptember 15, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1528164936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4079 LAKE RD N, Brockport, NY 14420
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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

Other Providers at the Same Location NPPES

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

MS. KRISTY GENUNG DIBELKA LMT
Massage Therapist
4079 LAKE RD N
BROCKPORT, NY 14420
Monroe County (585) 697-4489

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 Evergreen Family Medicine, PC's NPI number?

The NPI number for Evergreen Family Medicine, PC is 1528164936. It was assigned to this organization in the NPPES registry on September 15, 2006.

Where is Evergreen Family Medicine, PC located?

Evergreen Family Medicine, PC is located at 4079 Lake Rd N, Brockport, NY 14420. The listed phone number is (585) 637-0151.

What is Evergreen Family Medicine, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Evergreen Family Medicine, PC 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 6 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.