Mid Hudson Plastic Surgery PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

2017201 Issued in NY

Legal business name

MID HUDSON PLASTIC SURGERY PC

Practice address

117 Marys Ave
Suite 204
Kingston, NY 12401-5849

Phone

(845) 338-0789

Fax

(845) 334-9150

NPI assigned

Sep 15, 2005

Reactivated

Mar 5, 2009

Last updated

Sep 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Hagerty, MDNPI 1831184449

Title

Group Owner

Phone

(845) 338-0799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas A. Hagerty, MD

  • Plastic Surgery Physician
  • Kingston, NY
  • NPI 1831184449
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1144215161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MARYS AVE",
            "address_2": "SUITE 204",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015849",
            "telephone_number": "845-338-0789",
            "fax_number": "845-334-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MARYS AVE",
            "address_2": "SUITE 204",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015849",
            "telephone_number": "845-338-0789",
            "fax_number": "845-334-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID HUDSON PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2016-09-21",
        "deactivation_date": "2008-06-10",
        "reactivation_date": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "HAGERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "GROUP OWNER",
        "authorized_official_telephone_number": "845-338-0799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "2017201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Metzler, LMSW
• Marissa Rebecca Meyer, RN
• Michael S Hahn MD PC
• Mid Hudson Chiropractic PC
• Mid Hudson Physicians, P.C.
• Mid Hudson Psychological Services PLLC
• Mid-Hudson Oral and Maxillofacial PC
• Mid-Valley Comprehensive OB-GYN PC
• Lucia Milla, MD
• Anna Millenson, LCSW

• Plastic Surgery Physician in Kingston, NY
• Providers in Kingston, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.