Individual provider Active NPI

Erin Mackay

  • Physician Assistant
  • Hauppauge, NY
National Provider Identifier
1114465754
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18 Sequoia Dr
Hauppauge, NY 11788-2626
Phone
(631) 487-3328
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 Primary

Addresses

Primary practice location

18 Sequoia Dr
Hauppauge, NY 11788-2626

Mailing address

18 Sequoia Dr
Hauppauge, NY 11788-2626

Other practice location 1

540 Union Blvd
West Islip, NY 11795-3105
Phone (631) 669-2555

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
I20230721002782 NY Practitioner - Physician Assistant 1850790874 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital CurrentSince May 14, 2023 Accepting new patients
St Francis Hospital CurrentSince May 14, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Feb 25, 2021 Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

540 Union Blvd
West Islip, NY 11795
Phone (631) 669-2555

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1114465754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SEQUOIA DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SEQUOIA DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882626",
            "telephone_number": "631-487-3328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Union Blvd",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117953105",
            "country_code": "US",
            "telephone_number": "631-669-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "ERIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.