John Raymond Wanamaker, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

189611 Issued in NY

Practice address

800 Irving Ave
VA Medical Center, Surgical Services(112)
Syracuse, NY 13210-2716

Phone

(315) 425-4400

Fax

(315) 425-2639

NPI assigned

Oct 5, 2005

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

Practice roles

Interoperability endpoints

• Direct secure messaging: john.wanamaker.1@9322.direct.athenahealth.com

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.

• Ear Consultants of Central New York, PLLC

  • Otolaryngology Physician
  • Syracuse, NY
  • NPI 1881615862
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1386631166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "address_2": "VA MEDICAL CENTER, SURGICAL SERVICES(112)",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400",
            "fax_number": "315-425-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRVING AVE",
            "address_2": "VA MEDICAL CENTER, SURGICAL SERVICES(112)",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102716",
            "telephone_number": "315-425-4400",
            "fax_number": "315-425-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANAMAKER",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "189611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01635029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cailey Walton, MD
• Jennifer Marie Walton, LCSW
• Colleen Margaret Waltz Curr, NP
• James P Walzer, DC
• Hayes Wanamaker, MD
• Kathleen Elizabeth Wandell, PA-S
• Alice Wang, MD
• Michelle Wang, MD
• William Xiji Wang
• Xiaoting Wang, MBBS

• Otolaryngology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.