Individual provider Active NPI

Jordan Haskins, PA

  • Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1114300902
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018693 Issued in NY
Practice address
1910 South Rd
Poughkeepsie, NY 12601-6027
Phone
(845) 454-0120
Fax
(845) 790-2131
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018693 NY Primary

Addresses

Primary practice location

1910 South Rd
Poughkeepsie, NY 12601-6027

Mailing address

1910 South Rd
Poughkeepsie, NY 12601-6027
Phone (845) 454-0120

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730010579 NY Practitioner - Physician Assistant 8426362872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000

79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612

Hospital & facility affiliations

  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.44
Promoting interoperability
97.95
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
018693NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Assoc of Dutchess County P C Physician Assistant CurrentSince Sep 1, 2015 Accepting new patients
Orthopedic Assoc of Dutchess County P C CurrentSince Sep 1, 2015 Accepting new patients
Glens Falls Hospital Inc CurrentSince Sep 11, 2017 Accepting new patients

Locations

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

918 Ulster Ave
Kingston, NY 12401
Phone (845) 339-8900

3141 US Route 9W
Ste 100
New Windsor, NY 12553
Phone (845) 454-0120

1910 South Rd
Poughkeepsie, NY 12601
Phone (845) 454-0120

Interoperability endpoints

  • Direct secure messaging: jhaskins21004@albanymed.direct-ci.com

Organizations & group practices 5

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 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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1114300902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SOUTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126016027",
            "telephone_number": "845-454-0120",
            "fax_number": "845-790-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SOUTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126016027",
            "telephone_number": "845-454-0120",
            "fax_number": "845-790-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKINS",
        "first_name": "JORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.