Individual provider Active NPI

William Lewis Enslow Jr., D.O.

  • Emergency Medicine Physician
  • Ithaca, NY
National Provider Identifier
1437297157
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
314141 Issued in NY
Practice address
101 Dates Dr
Ithaca, NY 14850-1383
Phone
(607) 274-4514
NPI assigned
Feb 2, 2007
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 314141 NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1383

Mailing address

101 Dates Dr
Ithaca, NY 14850-1383
Phone (607) 274-4514

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
I20220208002221 NY Practitioner - Emergency Medicine 1254500846 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cma Medical Practice PLLCGroup PAC ID 7618214560, 28 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
314141NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Jan 14, 2026 Accepting new patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Schuyler Hospital Inc CurrentSince Aug 15, 2023 Accepting new patients
Cma Medical Practice PLLC Emergency Medicine CurrentSince Feb 20, 2022 Accepting new patients

Locations

1129 Commons Ave
#C
Cortland, NY 13045
Phone (607) 339-0456

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

Interoperability endpoints

  • Direct secure messaging: wenslow916439@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1437297157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-274-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-274-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSLOW",
        "first_name": "WILLIAM",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "314141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.