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

Individual provider Surgical Physician Assistant · NPI 1700136777

Taylor J Indivero, PA is a Physician Assistant in Rochester, New York. Qualified in 2012, 14 years ago. Practices with Western New York Medical Practice PC, a 528-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
14
Licensed in
NY
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1415 Portland Ave
Rochester, NY 14621-3038
Phone: (585) 922-2906
Fax: (585) 922-2951
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X (NY)

Record details

NPI number1700136777
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 17, 2012
Last updated in NPPESMarch 4, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Western New York Medical Practice Pc — 528 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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