National Provider Identifier

Jacob Scott Privitera, PA-C

Jacob Scott Privitera, PA-C is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 275-3022.

NPI 1023569431Rochester, NYSurgical Physician Assistant

Profile Overview

NPI
1023569431
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
October 20, 2016
Last Updated
June 29, 2023

Practice Location

  • 601 Elmwood Ave Box Surg
  • Rochester, NY 14642-0001

Phone: (585) 275-3022

Mailing Address

  • 601 Elmwood Avenue Box Surg
  • Rochester, NY 14642-9616

Specialties

  • Surgical Physician Assistant (363AS0400X)
  • Medical Physician Assistant (363AM0700X)
  • Trauma Surgery Physician (2086S0127X)

Endpoints

  • jprivitera107410@direct.urmc.rochester.edu

    Direct Messaging Address | Direct | Other | Rochester, NY 14642

Full Record
NPI
1023569431
Entity Type
Individual
Last Name
Privitera
First Name
Jacob
Middle Name
Scott
Name Prefix
Mr.
Credential
PA-C
Mailing Street Address
601 Elmwood Avenue Box Surg
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-9616
Mailing Country
US
Mailing Phone
(585) 275-5100
Mailing Fax
(585) 276-1992
Practice Street Address
601 Elmwood Ave Box Surg
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14642-0001
Practice Country
US
Practice Phone
(585) 275-3022
Enumeration Date
October 20, 2016
Last Updated
June 29, 2023
Sex
Male
Sole Proprietor
No
Certification Date
January 03, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X), Medical Physician Assistant (363AM0700X), Trauma Surgery Physician (2086S0127X)