Individual provider Active NPI

Mustafa Kaakour, MD

  • Cytopathology Physician
  • Utica, NY
National Provider Identifier
1245393040
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
1894621 Issued in NY
Practice address
1656 Champlin Ave
Department of Pathology
Utica, NY 13502-4830
Phone
(315) 797-0790
Fax
(315) 624-8204
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 1894621 NY Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 1894621 NY

Addresses

Primary practice location

1656 Champlin Ave
Department of Pathology
Utica, NY 13502-4830

Mailing address

117 Sylvan Way
New Hartford, NY 13413-3436
Phone (315) 724-4429

Other identifiers 1

IdentifierTypeStateIssuer
81472OtherNYEMPIRE BC BS

Other names 1

  • Dr. Mustafa Abdul Hadi Ka' Kur Former name

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
I20200316000414 NY Practitioner - Pathology 4183052731 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1894621NYMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 1, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jan 1, 2020 Accepting new patients

Locations

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245393040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SYLVAN WAY",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133436",
            "telephone_number": "315-724-4429",
            "fax_number": "315-724-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-797-0790",
            "fax_number": "315-624-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAAKOUR",
        "first_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "1894621",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "1894621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "81472",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MUSTAFA",
            "last_name": "KA' KUR",
            "middle_name": "ABDUL HADI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.