Individual provider Active NPI

Mary Hittner

  • Registered Nurse
  • Olean, NY
National Provider Identifier
1134559628
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4326981 Issued in NY
Practice address
1 Leo Moss Dr
Olean, NY 14760-1100
Phone
(716) 373-8040
Fax
(716) 701-3729
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4326981 NY Primary

Addresses

Primary practice location

1 Leo Moss Dr
Olean, NY 14760-1100

Mailing address

1 Leo Moss Dr
Olean, NY 14760-1100
Phone (716) 373-8040

Other identifiers 1

IdentifierTypeStateIssuer
00635098MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
4326981NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1134559628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LEO MOSS DR",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601100",
            "telephone_number": "716-373-8040",
            "fax_number": "716-701-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LEO MOSS DR",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601100",
            "telephone_number": "716-373-8040",
            "fax_number": "716-701-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITTNER",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "4326981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00635098",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.