Individual provider Active NPI

Adam Law, M.D.

  • Internal Medicine Physician
  • Ithaca, NY
National Provider Identifier
1023014974
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
187756-1 Issued in NY
Practice address
404 N Cayuga St
Ithaca, NY 14850-4219
Phone
(607) 277-0969
Fax
(607) 277-3242
NPI assigned
Jun 24, 2005
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 187756-1 NY Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 187756-1 NY

Addresses

Primary practice location

404 N Cayuga St
Ithaca, NY 14850-4219

Mailing address

404 N Cayuga St
Ithaca, NY 14850-4219
Phone (607) 277-0969

Other identifiers 6

IdentifierTypeStateIssuer
1088OtherNYTOTAL CARE GROUP
2734852MedicaidNY
968698OtherNYMVP
6591OtherNYTOTAL CARE
888009123OtherNYEXCELLUS
01332970MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000224 NY Practitioner - Internal MedicinePractitioner - Endocrinology 3678523586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
187756-1NYMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1023014974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N CAYUGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504219",
            "telephone_number": "607-277-0969",
            "fax_number": "607-277-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N CAYUGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504219",
            "telephone_number": "607-277-0969",
            "fax_number": "607-277-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "187756-1",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "187756-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE GROUP",
            "identifier": "1088",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2734852",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "968698",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE",
            "identifier": "6591",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "888009123",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01332970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.