Individual provider Active NPI

Russell M. Higley, P.A.

  • Physician Assistant
  • Fishkill, NY
National Provider Identifier
1124283684
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000348 Issued in NY
Practice address
200 Westage Business Center Drive
Suite 224
Fishkill, NY 12524
Phone
(845) 896-9200
Fax
(845) 896-3262
NPI assigned
Jul 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 000348 NY Primary

Addresses

Primary practice location

200 Westage Business Center Drive
Suite 224
Fishkill, NY 12524

Mailing address

200 Westage Business Center Drive
Suite 224
Fishkill, NY 12524
Phone (845) 896-9200

Other identifiers 1

IdentifierTypeStateIssuer
000348OtherNYNYS LICENSE

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000348NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Neurosurgical PLLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124283684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WESTAGE BUSINESS CENTER DRIVE",
            "address_2": "SUITE 224",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "12524",
            "telephone_number": "845-896-9200",
            "fax_number": "845-896-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WESTAGE BUSINESS CENTER DRIVE",
            "address_2": "SUITE 224",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "12524",
            "telephone_number": "845-896-9200",
            "fax_number": "845-896-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGLEY",
        "first_name": "RUSSELL",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "000348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "000348",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.