Cynthia J Provow, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

259347 Issued in NY

Practice address

80 State Highway 310 Ste 1
Canton, NY 13617-1436

Phone

(315) 386-2189

Fax

(315) 386-2435

NPI assigned

Nov 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

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.

• David P.Gorman, MD PC

  • Adult Health Nurse Practitioner
  • Plattsburgh, NY
  • NPI 1447387618
  NPD (past)
• St Lawrence County

  • Community/Behavioral Health Agency
  • Canton, NY
  • NPI 1699898635
  NPD (past)
• St Lawrence County

  • Multi-Specialty Clinic/Center
  • Canton, NY
  • NPI 1861551822
  NPD (past)
• Tae Sik Choi MD PC

  • Obstetrics & Gynecology Physician
  • Massena, NY
  • NPI 1922038116
  NPD (past)
• Berkshire Faculty Services

  • Obstetrics & Gynecology Physician
  • Pittsfield, MA
  • NPI 1265423008
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922288844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171436",
            "telephone_number": "315-386-2189",
            "fax_number": "315-386-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310 STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171436",
            "telephone_number": "315-386-2189",
            "fax_number": "315-386-2435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Center St",
            "address_purpose": "LOCATION",
            "city": "Massena",
            "state": "NY",
            "postal_code": "136621437",
            "country_code": "US",
            "telephone_number": "315-764-0265",
            "fax_number": "315-764-5941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVOW",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "234215",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "259347",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "259347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "AA103237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNE",
            "identifier": "42392",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Poste
• Christin Powers, PA
• Rochelle L Pratt, RN
• Michael Paul Preston
• Patti L Prouty, OTR
• Relani Prudhomme, LCSW
• Brooke C Pryce
• R R S Inc
• R.B. Lawrence Inc.
• Terry M. Rafferty, LMSW

• General Practice Physician in Canton, NY
• Providers in Canton, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.