Active NPI
William Albert Crockett, DO
- Urology Physician
- Bryn Mawr, PA
National Provider Identifier
1003745951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- OT025414
- Practice address
- 130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121 - Phone
- (866) 225-5654
- NPI assigned
- May 18, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | OT025414 | PA | Primary |
Addresses
Primary practice location
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Mailing address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (866) 225-5654
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260529004091 | PA | Order and Referring Only - Urology | 3072083096 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT025414 | PA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779062400000",
"number": "1003745951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "866-225-5654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "866-225-5654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "WILLIAM",
"middle_name": "ALBERT",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-18",
"last_updated": "2026-05-18",
"certification_date": "2026-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "OT025414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.