Syed Armoghan Wali, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125056998 Issued in NY

Practice address

15 Raymond St
Potsdam, NY 13676-1163

Phone

(315) 265-9271

NPI assigned

Aug 17, 2009

Last updated

Mar 31, 2021By 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 4

Addresses

Other identifiers 8

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swali325786@direct.rochesterregional.org

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.

• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Medicare reassignment NPD
• Canton-Potsdam Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potsdam, NY
  • NPI 1114104445
  NPD
• Canton Potsdam Hospital

  • Physical Therapy Clinic/Center
  • Canton, NY
  • NPI 1770703522
  NPD (past)
• Pediatrics Plus, P.C.

  • Pediatric Nurse Practitioner
  • Anniston, AL
  • NPI 1104137439

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1346472826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761799",
            "telephone_number": "315-265-3300",
            "fax_number": "315-261-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RAYMOND ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761163",
            "telephone_number": "315-265-9271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3312 Henry Rd",
            "address_purpose": "LOCATION",
            "city": "Anniston",
            "state": "AL",
            "postal_code": "362076344",
            "country_code": "US",
            "telephone_number": "256-241-2671",
            "fax_number": "256-241-2676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 LeRoy St",
            "address_purpose": "LOCATION",
            "city": "Potsdam",
            "state": "NY",
            "postal_code": "136761786",
            "country_code": "US",
            "telephone_number": "315-265-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALI",
        "first_name": "SYED",
        "middle_name": "ARMOGHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-17",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125056998",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "31880",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "296489",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "125056998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "511-30395 (SBC)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "511-30392(STEWART)",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "511-30389 (COMPLEX)",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141861 (COMPLEX)",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142072 (STEWART)",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183210",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "511-73964",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141862 (SBC)",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Alice Wais, N.P.
• Wal-Mart Stores East LP (Vision Center 30-3329)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3329)
• Walgreen Co (Walgreens #10293)
• Walgreens
• Paul G. Walker Jr., PAC
• Eric L Walter, MD
• Krista L Warren, RN
• Moriah J Warren
• Melinda Lucie Weatherwax, LPN

• Pediatrics Physician in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.