Individual provider Active NPI

Olivia Haney

  • Surgery Physician
  • Staten Island, NY
National Provider Identifier
1104212687
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
308612 Issued in NY
Practice address
256 Mason Ave
Staten Island, NY 10305-3408
Phone
(718) 226-1268
NPI assigned
Apr 10, 2015
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 308612 NY Primary

Addresses

Primary practice location

256 Mason Ave
Staten Island, NY 10305-3408

Mailing address

50 Murray St Apt 717
New York, NY 10007-2263
Phone (423) 967-9636

Other practice location 1

10 S Main St
Apt 1105
Memphis, TN 38103-2454
Phone (423) 967-9636

Other names 1

  • Olivia Morin Former name

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
I20221021000190 NY Practitioner - General Surgery 4587984885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

242 Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6832

256 Mason Ave
Staten Island, NY 10305-3408

256 Mason Ave B
Staten Island, NY 10305-3408
Phone (718) 226-1595

256 Mason Aveunue
Staten Island, NY 10305-3408
Phone (718) 226-1458

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308612NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 12, 2022 Accepting new patients
Staten Island University Hospital Past Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

256 Mason Ave
Staten Island, NY 10305
Phone (718) 226-9508

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: dr_olivia_morin@yourcarecommunity.org
  • Direct secure messaging: ohaney65009@northwell.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1104212687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MURRAY ST APT 717",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100072263",
            "telephone_number": "423-967-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 S Main St",
            "address_2": "Apt 1105",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032454",
            "country_code": "US",
            "telephone_number": "423-967-9636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANEY",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "308612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MORIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.