MR. THEODORE HOWARD VINEYARD NP
NPI 1689954091
Nurse Practitioner - Adult Health in Rochester, NY
About Mr. Theodore Howard Vineyard Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. THEODORE HOWARD VINEYARD NP (NPI 1689954091) is an individual adult health provider in Rochester, New York, licensed in New York (F305756-1) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Theodore Howard Vineyard Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Theodore Vineyard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Rochester, NY 14642
- Reassigned Medicare billing, New York enrollment
- 35 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
ROCHESTER, NY 14642
ROCHESTER, NY 14642
ROCHESTER, NY 14642
ROCHESTER, NY 14642
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 Theodore Vineyard's NPI number?
The NPI number for Theodore Vineyard is 1689954091. It was assigned to this individual provider in the NPPES registry on August 17, 2011.
Where is Theodore Vineyard located?
Theodore Vineyard practices at 601 Elmwood Ave Box Surg 8-3600, Rochester, NY 14642. The listed phone number is (585) 275-2113.
What is Theodore Vineyard's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Theodore Vineyard enrolled in Medicare?
Yes. Theodore Vineyard is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Theodore Vineyard's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Vineyard reassigns Medicare benefits to University Cardiothoracic Surgery Group (Rochester, NY). 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 Theodore Vineyard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Theodore Vineyard was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mr. Theodore Howard Vineyard, NP · NPI 1689954091
Adult Health physician in Rochester, New York. Individual provider, active in the CMS NPPES registry since August 17, 2011.
## Identity
- **NPI:** 1689954091 (Entity type: Individual)
- **Enumerated:** August 17, 2011
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** F305756-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 601 ELMWOOD AVE, BOX SURG 8-3600, Rochester, NY 14642-0001
- **Phone:** (585) 275-2113
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Cardiothoracic Surgery Group (NPI 1154342285, Rochester, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 6, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1689954091) · Data from the CMS NPPES public registry.