Active NPI
Haley Joy Magnetta, PA-C
- Physician Assistant
- Torrington, CT
National Provider Identifier
1134500010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3722
- Practice address
- 540 Litchfield St
Torrington, CT 06790-6600 - Phone
- (860) 496-6666
- NPI assigned
- Jun 16, 2015
- Last updated
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 52581 | CA | |
| Physician Assistant | 363A00000X | 3722 | CT | Primary |
Addresses
Primary practice location
540 Litchfield St
Torrington, CT 06790-6600
Mailing address
900 Chapel St Apt 308
New Haven, CT 06510-2802
Phone (630) 418-1991
Other practice location 1
808 W 58th St
Los Angeles, CA 90037-3632
Phone (323) 541-1600
Other names 1
- Haley Joy Wareham
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52581 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1134500010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 CHAPEL ST APT 308",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065102802",
"telephone_number": "630-418-1991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 LITCHFIELD ST",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906600",
"telephone_number": "860-496-6666"
}
],
"practiceLocations": [
{
"address_1": "808 W 58th St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900373632",
"country_code": "US",
"telephone_number": "323-541-1600",
"fax_number": "323-541-1661",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAGNETTA",
"first_name": "HALEY JOY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "52581",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "3722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HALEY",
"last_name": "WAREHAM",
"middle_name": "JOY",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Torrington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.