Individual provider · Type 1 NPI

Madison Ricketts

Medical Physician Assistant · Rochester, NY

NPI number 1700629862 Active

Practice location

1415 Portland Ave Ste 400
Rochester, NY 14621-3022

Fax (585) 922-4922

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice locations

  • 33 Chandler Ave, Batavia, NY 14020-1684 · (585) 344-4700
  • 222 Alexander St Ste 1100, Rochester, NY 14607-4005 · (585) 922-8585
  • 293 Upper Falls Blvd, Rochester, NY 14605-2184 · (585) 922-0260

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X032375 (NY)

Medical Physician Assistant: Definition to come...

14 other providers at this address

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About NPI 1700629862

Madison Ricketts's National Provider Identifier is 1700629862, issued on Jun 17, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rochester, NY. The record was last updated on Mar 31, 2026.