Provider Demographics
NPI:1184625204
Name:ALEXIS, JEFFREY DEAN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DEAN
Last Name:ALEXIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 679B
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-276-9761
Mailing Address - Fax:585-427-8718
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 679B
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-276-9761
Practice Address - Fax:585-427-8718
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199837207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01924776Medicaid
NY51B811Medicare ID - Type Unspecified
NYG85297Medicare UPIN