Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ayodele C Ippolito

Individual provider Physician Assistant · NPI 1639897788

Ayodele C Ippolito is a Physician Assistant in Rochester, New York. Qualified in 2022, 4 years ago. Practices with University of Rochester, a 962-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2613 W Henrietta Rd Ste B
Rochester, NY 14623-2327
Phone: (585) 279-4999
Fax: (585) 473-5152
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 029370 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 29370 (NY)

Record details

NPI number1639897788
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 16, 2022
Last updated in NPPESJuly 22, 2023
Certification dateNovember 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice University Of Rochester — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Rochester