Individual provider Active NPI

Mark E Williams, M.D.

  • Surgery Physician
  • Rome, NY
National Provider Identifier
1710971866
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
202473 Issued in NY
Practice address
1500 N James St
Rome, NY 13440-2844
Phone
(315) 338-7184
Fax
(315) 338-1975
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 202473 NY Primary

Addresses

Primary practice location

1500 N James St
Rome, NY 13440-2844

Mailing address

PO Box 2000
East Syracuse, NY 13057-4500
Phone (315) 362-5129

Other identifiers 1

IdentifierTypeStateIssuer
01863978MedicaidNY

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
I20040428000963 NY Practitioner - General Surgery 8224021902 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rome Memorial Hospital, Inc. Current Accepting new patients

Locations

107 E Chestnut St
Ste 102
Rome, NY 13440
Phone (315) 338-9200

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

Interoperability endpoints

  • Direct secure messaging: mwilliams3@rmh.medalliesdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1710971866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574500",
            "telephone_number": "315-362-5129",
            "fax_number": "315-362-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N JAMES ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402844",
            "telephone_number": "315-338-7184",
            "fax_number": "315-338-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "202473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01863978",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

Verify at the official NPI Registry.