Individual provider Active NPI

Adrienne Moore Haughton, MD

  • Dermatology Physician
  • Long Beach, NY
National Provider Identifier
1215021191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
239933-1 Issued in NY
Practice address
604 E Park Ave
Long Beach, NY 11561-2505
Phone
(516) 432-0011
Fax
(516) 432-1686
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 239933-1 NY Primary

Addresses

Primary practice location

604 E Park Ave
Long Beach, NY 11561-2505

Mailing address

604 E Park Ave
Long Beach, NY 11561-2505
Phone (516) 432-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061229000344 NY Practitioner - Dermatology 3678573490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1320 Stony Brook Rd
Suite 200
Stony Brook, NY 11790-2215
Phone (631) 444-4200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions101
Skin biopsy133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
239933-1NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Dermatology Associates, University Faculty Practice Corpor Dermatology CurrentSince Aug 15, 2010 Accepting new patients
Schweiger Dermatology PLLC Dermatology PastSince Nov 1, 2017 Accepting new patients

Locations

500 Commack Rd
Ste 105
Commack, NY 11725

1320 Stony Brook Rd
Bldg F200
Stony Brook, NY 11790
Phone (631) 444-3843

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: adrienne.haughton@direct.stonybrookmedicine.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215021191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612505",
            "telephone_number": "516-432-0011",
            "fax_number": "516-432-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612505",
            "telephone_number": "516-432-0011",
            "fax_number": "516-432-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHTON",
        "first_name": "ADRIENNE",
        "middle_name": "MOORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "239933-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.