William A Mandour, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

125882 Issued in NY

Practice address

2 Ellinwood Dr
New Hartford, NY 13413-1102

Phone

(315) 724-1012

Fax

(315) 724-5219

NPI assigned

Nov 3, 2005

Last updated

Jun 22, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• W Anthony Mandour Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Utica Urologic Associates, P.C.

  • Urology Physician
  • Utica, NY
  • NPI 1073690830
  NPD

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1164413662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELLINWOOD DR",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131102",
            "telephone_number": "315-724-1012",
            "fax_number": "315-724-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDOUR",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "125882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00597879",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W",
            "last_name": "MANDOUR",
            "middle_name": "ANTHONY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Timothy John Madden, PT, DPT, DME
• Matthew James Madia, ATC
• Kevin Mahoney, PA
• Mak Orthopaedics PLLC
• Shauna L Malta
• Samuel Maneen, R.PH.
• Anthony R Mangano, MD
• Kelly Mangione, CCC-SLP
• Srinivasan S Mani, M.D.
• Karina Manino, RDH

• Urology Physician in New Hartford, NY
• Providers in New Hartford, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.