Individual provider Active NPI

Gregory Martin Haney, DPT

  • Physical Therapist
  • Malden, MA
National Provider Identifier
1184957417
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18312 Issued in MA
Practice address
350 Main St
First Floor
Malden, MA 02148-5089
Phone
(781) 321-2727
Fax
(781) 321-4995
NPI assigned
Sep 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18312 MA Primary

Addresses

Primary practice location

350 Main St
First Floor
Malden, MA 02148-5089

Mailing address

350 Main St
First Floor
Malden, MA 02148-5089
Phone (781) 321-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140620001649 CT Practitioner - Physical Therapist in Private Practice 7618008707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

225 Kennedy Dr
Suite B
Putnam, CT 06260-1662
Phone (413) 244-9101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18312MAMDOral and Maxillofacial Surgery (Dentist)
9991CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Physical Therapy, LLC CurrentSince Apr 1, 2019 Accepting new patients
McGovern Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Byron V Hartunian MD PC Past Accepting new patients

Locations

225 Kennedy Dr
Putnam, CT 06260
Phone (860) 315-9009

82 Providence St
Putnam, CT 06260
Phone (860) 315-9123

225 Kennedy Dr
Ste B
Putnam, CT 06260
Phone (413) 244-9101

Organizations & group practices 3

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": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1184957417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "address_2": "FIRST FLOOR",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485089",
            "telephone_number": "781-321-2727",
            "fax_number": "781-321-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "address_2": "FIRST FLOOR",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485089",
            "telephone_number": "781-321-2727",
            "fax_number": "781-321-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "GREGORY",
        "middle_name": "MARTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.