Active NPI
Hayes Wanamaker, MD
- Otolaryngology Physician
- Syracuse, NY
National Provider Identifier
1528055308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 1722581
- Practice address
- 721 E Genesee St
FL 2ND
Syracuse, NY 13210-1505 - Phone
- (315) 476-3127
- Fax
- (315) 476-3136
- NPI assigned
- Oct 5, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 1722581 | NY | Primary |
Addresses
Primary practice location
721 E Genesee St
FL 2ND
Syracuse, NY 13210-1505
Mailing address
721 E Genesee St
FL 2ND
Syracuse, NY 13210-1505
Phone (315) 476-3127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01258828 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1722581 | NY | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cny Ear Nose Throat Consultants | Otolaryngology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Syracuse, NY
- NPI 1225080393
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1528055308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 E GENESEE ST",
"address_2": "FL 2ND",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101505",
"telephone_number": "315-476-3127",
"fax_number": "315-476-3136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 E GENESEE ST",
"address_2": "FL 2ND",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101505",
"telephone_number": "315-476-3127",
"fax_number": "315-476-3136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANAMAKER",
"first_name": "HAYES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NY",
"license": "1722581",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01258828",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.