Individual provider Active NPI

William Supplee, MD

  • Internal Medicine Physician
  • Ithaca, NY
National Provider Identifier
1972009785
Registry record updated Jan 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
319435-1 Issued in NY
Practice address
101 Dates Dr
Ithaca, NY 14850-1383
Phone
(607) 339-0494
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A166747 CA
Addiction Medicine (Internal Medicine) Physician 207RA0401X 319435-1 NY
Internal Medicine Physician 207R00000X 319435-1 NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1383

Mailing address

101 Dates Dr
Ithaca, NY 14850-1383
Phone (607) 339-0494

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
I20240812002213 NY Practitioner - HospitalistPractitioner - Internal Medicine 7315485125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4296

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

40 Catherwood Rd
Ithaca, NY 14850-1056
Phone (607) 272-0460

Hospital & facility affiliations

  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307
  • Schuyler Hospital Hospital, Montour Falls, NY, CCN 331313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166747CAMDInternal Medicine Physician
319435-1NYMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Associates, PC Internal Medicine CurrentSince Sep 2, 2024 Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: william.supplee.1@17251.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1972009785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-339-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-339-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLEE",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A166747",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NY",
            "license": "319435-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "319435-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.