JACK SCHEUTZOW
NPI 1609627165
Student in an Organized Health Care Education/Training Program in Rochester, NY

Q: What is Jack Scheutzow's NPI number?

The NPI number for Jack Scheutzow is 1609627165. It was assigned to this individual provider in the NPPES registry on April 1, 2024.

Q: What is Jack Scheutzow's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Scheutzow was last updated on April 1, 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.

Active since April 01, 2024PECOS Enrolled

777 CLINTON AVE S, ROCHESTER, NY 14620(585) 279-4800(585) 442-8319 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jack Scheutzow NPPES

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

JACK SCHEUTZOW (NPI 1609627165) is an individual student in an organized health care education/training program in Rochester, New York and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609627165

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK SCHEUTZOW

Location Address777 CLINTON AVE SRochester, NY 14620-1448

Mailing Address777 Clinton Ave SRochester, NY 14620-1448 · (585) 279-4800 · Fax (585) 442-8319

Phone(585) 279-4800

Fax(585) 442-8319

Sole ProprietorNo

Enumeration DateApril 1, 2024

NPPES CertifiedApril 1, 2024

✔ NPI 1609627165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

777 CLINTON AVE S, Rochester, NY 14620

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Scheutzow is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

SOPHIA EMMANUELLE HANNA DO

Student in an Organized Health Care Education/Training Program