Individual provider Active NPI

Ma Khin Khin Win

  • Pediatrics Physician
  • Norwich, NY
National Provider Identifier
1609255249
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
300024 Issued in NY
Practice address
4 Newton Ave
Norwich, NY 13815-1153
Phone
(607) 337-4910
Fax
(607) 337-4915
NPI assigned
May 28, 2015
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 300024 NY Primary

Addresses

Primary practice location

4 Newton Ave
Norwich, NY 13815-1153

Mailing address

54 Borden Ave Apt B22
Norwich, NY 13815-1173
Phone (347) 630-5780

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
I20190813002593 NY Practitioner - Pediatric Medicine 8123365376 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chenango Memorial Hospital Inc CurrentSince Aug 5, 2019 Accepting new patients
Chenango Memorial Hospital, Inc. Pediatrics CurrentSince Aug 5, 2019 Accepting new patients
Chenango Memorial Hospital Inc Current Accepting new patients

Locations

179 N Broad St
Norwich, NY 13815
Phone (607) 337-4111

4 Newton Ave
Norwich, NY 13815
Phone (607) 337-4139

Interoperability endpoints

  • Direct secure messaging: mwin8781@prd.direct.tbh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1609255249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BORDEN AVE APT B22",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151173",
            "telephone_number": "347-630-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NEWTON AVE",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151153",
            "telephone_number": "607-337-4910",
            "fax_number": "607-337-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIN",
        "first_name": "MA KHIN KHIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "300024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.