| Oak Orchard Health | |
|
300 West Ave Brockport NY 14420-1118 | |
| (585) 637-3905 | |
| (585) 637-4990 |
| Full Name | Oak Orchard Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 West Ave, Brockport, New York |
| Authorized Official Name and Position | Karen Kinter (CEO) |
| Authorized Official Contact | 5856373905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Orchard Health 300 West Ave Brockport NY 14420-1118 Ph: (585) 637-3905 | Oak Orchard Health 300 West Ave Brockport NY 14420-1118 Ph: (585) 637-3905 |
| NPI Number | 1598707812 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 05/11/2023 |
| Medicare PECOS PAC ID | 5496746927 |
|---|---|
| Medicare Enrollment ID | O20040521001124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598707812 | NPI | - | NPPES |
| 704524 | Other | NY | EXCELLUS BS GROUP |
| 00355308 | Medicaid | NY |
| Provider Name | Pamela T Salzmann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932108149 PECOS PAC ID: 0941283667 Enrollment ID: I20040611001052 |
| Provider Name | Robert W Ford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790749471 PECOS PAC ID: 2961473368 Enrollment ID: I20040802000057 |
| Provider Name | Mary E Obear |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629034285 PECOS PAC ID: 8628021235 Enrollment ID: I20050822000128 |
| Provider Name | Yvonne M Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740248277 PECOS PAC ID: 3476551300 Enrollment ID: I20061201000013 |
| Provider Name | Mary T Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154380038 PECOS PAC ID: 4183751563 Enrollment ID: I20100415000688 |
| Provider Name | Uzma S Mehr |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114979101 PECOS PAC ID: 1658568829 Enrollment ID: I20101214000703 |
| Provider Name | Nashiha Shahid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225140619 PECOS PAC ID: 1153506878 Enrollment ID: I20110422000451 |
| Provider Name | Mohammadreza Azadfard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689841488 PECOS PAC ID: 9931386422 Enrollment ID: I20110609000601 |
| Provider Name | Muhammad Shahid Idrees |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073580783 PECOS PAC ID: 4981881489 Enrollment ID: I20110610000024 |
| Provider Name | Christina L Sobczak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164736526 PECOS PAC ID: 8426226366 Enrollment ID: I20110721000002 |
| Provider Name | Matthew Michael Fernaays |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699940940 PECOS PAC ID: 3173791530 Enrollment ID: I20110729000584 |
| Provider Name | Tamera S Suzanne Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386891059 PECOS PAC ID: 7012176969 Enrollment ID: I20120313000001 |
| Provider Name | Michelle L Okonieczny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306100730 PECOS PAC ID: 2668621533 Enrollment ID: I20121009000645 |
| Provider Name | Shirley L Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639422058 PECOS PAC ID: 9931497161 Enrollment ID: I20161004001056 |
| Provider Name | Keith Stephen Fuleki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801233135 PECOS PAC ID: 2961706718 Enrollment ID: I20180205002605 |
| Provider Name | Chanh C Huynh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447606215 PECOS PAC ID: 9638422538 Enrollment ID: I20190726002572 |
| Provider Name | Kelsey Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538592258 PECOS PAC ID: 1254668536 Enrollment ID: I20190808003055 |
| Provider Name | Kayleigh M Punch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871944520 PECOS PAC ID: 3476898800 Enrollment ID: I20190816000280 |
| Provider Name | Danielle Renodin-mead |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548569916 PECOS PAC ID: 2062743271 Enrollment ID: I20191018000819 |
| Provider Name | Jane Marie Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154883478 PECOS PAC ID: 9931409992 Enrollment ID: I20191112001012 |
| Provider Name | Shelby D Rojas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477199651 PECOS PAC ID: 4183035850 Enrollment ID: I20201201002996 |
| Provider Name | Timothy Wayne Eck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740887140 PECOS PAC ID: 0143632844 Enrollment ID: I20201222003003 |
| Provider Name | Dawn Warriner-herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912500992 PECOS PAC ID: 2668889916 Enrollment ID: I20210402000080 |
| Provider Name | David M Tinkelman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356671812 PECOS PAC ID: 8820406945 Enrollment ID: I20210409000050 |
| Provider Name | Minnie R Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811581762 PECOS PAC ID: 5890194450 Enrollment ID: I20210602000300 |
| Provider Name | Jennifer Lynn Alejandro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205436417 PECOS PAC ID: 5395149538 Enrollment ID: I20210810001439 |
| Provider Name | Jennifer Lee Fox Hand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174192983 PECOS PAC ID: 6406250497 Enrollment ID: I20210812003852 |
| Provider Name | Shenandoah Dole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861089039 PECOS PAC ID: 2466857826 Enrollment ID: I20210823002392 |
| Provider Name | Lyndzea Corsetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437818234 PECOS PAC ID: 3779975669 Enrollment ID: I20220127000328 |
| Provider Name | Shannon Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861154825 PECOS PAC ID: 7416342944 Enrollment ID: I20220321001541 |
| Provider Name | Jenna Rogge |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427673243 PECOS PAC ID: 8628464864 Enrollment ID: I20220415000166 |
| Provider Name | Holly A Partridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891438867 PECOS PAC ID: 8325423031 Enrollment ID: I20220916000791 |
| Provider Name | Emily Hein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164142675 PECOS PAC ID: 5698146835 Enrollment ID: I20230125002481 |
| Provider Name | Karen Mawn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487674941 PECOS PAC ID: 8123028073 Enrollment ID: I20230307001768 |
| Provider Name | Sarah E Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689295578 PECOS PAC ID: 3173942281 Enrollment ID: I20230802001166 |
| Provider Name | Kaitlyn Hamilton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912666975 PECOS PAC ID: 4183074479 Enrollment ID: I20231228003212 |
| Provider Name | Hayley Mandel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578947941 PECOS PAC ID: 2264883669 Enrollment ID: I20240110002840 |
| Provider Name | Robin Galbraith Govanlu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851712194 PECOS PAC ID: 9638521412 Enrollment ID: I20240117001983 |
| Provider Name | Emma Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265924682 PECOS PAC ID: 2264884782 Enrollment ID: I20240122000237 |
| Provider Name | Julie Solis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972138931 PECOS PAC ID: 9032562806 Enrollment ID: I20240129000642 |
| Provider Name | Marissa Lee Douglas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417600982 PECOS PAC ID: 6507219169 Enrollment ID: I20240130003362 |
| Provider Name | Erika Pozzuolo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134583826 PECOS PAC ID: 0648613075 Enrollment ID: I20240213001058 |
| Provider Name | Taylor C Bates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164029195 PECOS PAC ID: 7810336377 Enrollment ID: I20240416003506 |
Suny Brockport Student Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 New Campus Dr, Hazen Hall, Brockport, NY 14420 Phone: 585-395-2414 | |
Internal Medicine At Lakeside Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 106, Brockport, NY 14420 Phone: 585-395-6095 Fax: 585-395-6084 | |
Brockport Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 34 West Ave, Brockport, NY 14420 Phone: 585-637-2161 Fax: 585-637-5819 | |
Doctor Hany G Nissiem Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6565 Fourth Section Rd, Suite 300, Brockport, NY 14420 Phone: 585-395-0620 Fax: 585-395-0622 | |
Suri Karthikeyan Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 202, Brockport, NY 14420 Phone: 585-637-8580 Fax: 585-637-0471 | |
Evergreen Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4079 Lake Rd N, Brockport, NY 14420 Phone: 585-637-0151 Fax: 585-637-0562 | |
Rajendra Mehta And Leena Mehta Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 West Ave, Brockport, NY 14420 Phone: 585-637-9196 Fax: 585-637-3250 |