Individual provider Active NPI

Cynthia Mondesir, MD

  • Pediatrics Physician
  • Potsdam, NY
National Provider Identifier
1811163066
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
304675 Issued in NY
Practice address
15 Raymond St
Potsdam, NY 13676-1163
Phone
(315) 265-9271
Fax
(315) 265-4206
NPI assigned
May 7, 2008
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 304675 NY Primary
Pediatrics Physician 208000000X 6327 AK

Addresses

Primary practice location

15 Raymond St
Potsdam, NY 13676-1163

Mailing address

50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300

Other practice location 1

700 Chief Eddie Hoffman Highway
Bethel, AK 99559-0287
Phone (907) 543-6300

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
I20200630002517 NY Practitioner - Pediatric Medicine 9739376161 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Canton-Potsdam Hospital CurrentSince Jun 15, 2020 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jun 15, 2020 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

15 Raymond St
Potsdam, NY 13676
Phone (315) 265-1055

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Interoperability endpoints

  • Direct secure messaging: cmondesir338575@direct.rochesterregional.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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1811163066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RAYMOND ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761163",
            "telephone_number": "315-265-9271",
            "fax_number": "315-265-4206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Chief Eddie Hoffman Highway",
            "address_purpose": "LOCATION",
            "city": "Bethel",
            "state": "AK",
            "postal_code": "995590287",
            "country_code": "US",
            "telephone_number": "907-543-6300",
            "fax_number": "907-543-6366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONDESIR",
        "first_name": "CYNTHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "304675",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "6327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.