Active NPI
Jeffrey E. Hatter, M.D.
- Surgery Physician
- Kingston, NY
National Provider Identifier
1093704496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 230467
- Practice address
- 117 Marys Ave
Suite 201
Kingston, NY 12401-5849 - Phone
- (845) 331-5826
- Fax
- (845) 331-0438
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 230467 | NY | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 230467 | NY |
Addresses
Primary practice location
117 Marys Ave
Suite 201
Kingston, NY 12401-5849
Mailing address
117 Marys Ave
Suite 201
Kingston, NY 12401-5849
Phone (845) 331-5826
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2521433 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 230467 | NY | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vascular & Transplant Specialists PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Vascular Surgery Physician
- VA Beach, VA
- NPI 1104897636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1093704496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 MARYS AVE",
"address_2": "SUITE 201",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124015849",
"telephone_number": "845-331-5826",
"fax_number": "845-331-0438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 MARYS AVE",
"address_2": "SUITE 201",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124015849",
"telephone_number": "845-331-5826",
"fax_number": "845-331-0438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTER",
"first_name": "JEFFREY",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "230467",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NY",
"license": "230467",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2521433",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.