Alan G. Withiam, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

155579 Issued in NY

Practice address

1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202

Phone

(607) 869-5609

Fax

(607) 869-5303

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Finger Lakes Area Counseling and Recovery Agency, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Clifton Springs, NY
  • NPI 1366434011
  Medicare reassignment NPD
• Seneca Cayuga Counties Chapter Nysarc, Inc.

  • Voluntary or Charitable Agency
  • Waterloo, NY
  • NPI 1497804215
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871650697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 SWAMP COLLEGE RD",
            "city": "TRUMANSBURG",
            "state": "NY",
            "postal_code": "148869165",
            "telephone_number": "607-387-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 WATERLOO GENEVA RD",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651202",
            "telephone_number": "607-869-5609",
            "fax_number": "607-869-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHIAM",
        "first_name": "ALAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "155579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Gabrielle Wilkie, PT, DPT
• Austin Williams
• Tiffany Williams
• Meredith Williamson, PT
• Danielle Wilson
• Edward McMillan Wright, PT
• Linda Lee Young, LPN
• Kimberly Ann Zajac

• Family Medicine Physician in Waterloo, NY
• Providers in Waterloo, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.