Alan T Midura, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

162420 Issued in NY

Practice address

209 W State St
Ithaca, NY 14850-5429

Phone

(607) 257-5263

Fax

(607) 216-0902

NPI assigned

Oct 16, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285714469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505429",
            "telephone_number": "607-257-5263",
            "fax_number": "607-216-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505429",
            "telephone_number": "607-257-5263",
            "fax_number": "607-216-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDURA",
        "first_name": "ALAN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "162420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00898908",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jed A Michael
• Justinian Evangelos Michaels
• Michelle Kwintner
• Michelle Russo, LCSW
• Susan Michlovitz, PT
• Sharon Ryan Mier
• Patrycia Mikiciuk
• Paul Istvan Mikowski, PSY.D.
• Carol L Miller, M.A., ATR-BC, LCAT
• Elizabeth Miller, CCC-SLP

• Family Medicine Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.