Jennifer Ha

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

060119 Issued in NY

Practice address

1705 Broadway Ste 5
Hewlett, NY 11557-1600

Phone

(516) 514-7840

NPI assigned

Feb 15, 2017

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 30, 2021 through Aug 30, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• East Coast Endodontics, PC

  • Endodontics
  • Hewlett, NY
  • NPI 1891656732
  NPD

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1114466786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 BROADWAY STE 5",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 BROADWAY STE 5",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571600",
            "telephone_number": "516-514-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2021-09-02",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "060119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Edward Groeger, MD
• Aaron Brett Grotas, M.D.
• Jay Isaac Gruenfeld, D.D.S.
• GS Medical Consulting P.C.
• Lendsa Guillaume
• Ilanith I Hager Reuven, M.S. CCC/SLP
• Olga Haimov, FNP
• Hair Replacement One Inc
• Erica Faith Hartmann, PA-C
• Harvard Street Medical Associates, PC

• Endodontics in Hewlett, NY
• Providers in Hewlett, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.