Individual provider Active NPI

William A. Cook, M.D.

  • Specialist
  • Staten Island, NY
National Provider Identifier
1790773299
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
152888 Issued in NY
Practice address
1050 Clove Rd
Staten Island, NY 10301-3627
Phone
(718) 816-6440
Fax
(718) 816-3642
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 152888 NY Primary

Addresses

Primary practice location

1050 Clove Rd
Staten Island, NY 10301-3627

Mailing address

2791 Richmond Ave
Suite 201
Staten Island, NY 10314-5882
Phone (718) 816-6440

Other identifiers 1

IdentifierTypeStateIssuer
01546529MedicaidNY

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
I20080701000565 NY Practitioner - HematologyPractitioner - Internal Medicine 0345312633 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 21, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 21, 2017 Accepting new patients
Staten Island Physician Practice PC Past Accepting new patients

Locations

8201 37th Ave
Jackson Hts, NY 11372
Phone (718) 335-5800

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

275 7th Ave
Fl 4
New York, NY 10001
Phone (212) 812-3542

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10 Nathan D Perlman Pl
New York, NY 10003
Phone (212) 420-2124

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1790773299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVE",
            "address_2": "SUITE 201",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145882",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "152888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01546529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.