Kagnew A Mamo

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P140634 Issued in NY

Practice address

154 Prospect Ave # 12901
Plattsburgh, NY 12901-1302

Phone

(516) 862-1202

NPI assigned

Feb 23, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mill Basin Medical Health PCGroup PAC ID 9133566128, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mill Basin Medical Health PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346006202
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1831043397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 ELMWOOD ST APT 209",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 PROSPECT AVE # 12901",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011302",
            "telephone_number": "516-862-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMO",
        "first_name": "KAGNEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P140634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadeem Hussaain Maken, TRANSPORT PROVIDER
• Nidal Makhoul, MD FACC FACP
• Melissa Lyn Maki, LAC, AP
• Making Moves Transportation and Recovery Services
• Lee Ann Malseptic, RN
• Mandala Mental Health Counseling, PLLC
• Colleen M Manney
• Chelsea Lynn Manor, FNP-BC
• Elizabeth Manor
• Marc R Sarnow DPM

• Internal Medicine Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.