Kanchan M Mahon, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

211483 Issued in NY

Practice address

3220 Pearl St
Endwell, NY 13760-5758

Phone

(607) 748-9900

Fax

(607) 748-9800

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 26, 2017 through Jan 26, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• The Charlotte Hungerford Hospital

  • General Acute Care Hospital
  • Torrington, CT
  • NPI 1629075734
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245456000000",
    "number": "1326163239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-748-9900",
            "fax_number": "607-748-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 PEARL ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605758",
            "telephone_number": "607-748-9900",
            "fax_number": "607-748-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHON",
        "first_name": "KANCHAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "211483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Ann Lisak, OPHTHALMIC DISPENSER
• Paula A Loretz, OTR
• Eric Joseph Lorraine, DO
• Yvonne Mary Lucia, LMHC
• Tracy Lyman
• Maine Endwell Central School District
• Katrina Mallery
• Maria Therese Mallery, FNP
• Mary Clare Marasco, L/OTR
• Elizabeth Marie Meyer, C.O.T.A./L

• Psychiatry Physician in Endwell, NY
• Providers in Endwell, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.