Active NPI
William Sanders
- Physician Assistant
- Warrensburg, NY
National Provider Identifier
1235148776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004261
- Practice address
- 3767 Main St
Warrensburg, NY 12885-1837 - Phone
- (518) 623-2844
- Fax
- (518) 623-3416
- NPI assigned
- Aug 5, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004261 | NY | Primary |
Addresses
Primary practice location
3767 Main St
Warrensburg, NY 12885-1837
Mailing address
1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00630036 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004261 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1235148776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BROAD STREET PLZ",
"address_2": "PO BOX 357",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014390",
"telephone_number": "518-761-0300",
"fax_number": "518-745-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3767 MAIN ST",
"city": "WARRENSBURG",
"state": "NY",
"postal_code": "128851837",
"telephone_number": "518-623-2844",
"fax_number": "518-623-3416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004261",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00630036",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warrensburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.