Individual provider Active NPI

Elizabeth Ann Haughney, PA-C

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1215400627
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
259 1St St
Mineola, NY 11501-3987
Phone
(516) 663-0333
NPI assigned
Jan 8, 2019
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3987

Mailing address

259 1St St
Mineola, NY 11501-3957
Phone (516) 663-0333

Other practice location 1

321 Taylor Ave
Levittown, NY 11756-5609
Phone (516) 579-4506

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehaughney342091@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002856 NY Practitioner - Physician Assistant 2365876521 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023411NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Nov 1, 2021 Accepting new patients
New York University CurrentSince Nov 1, 2021 Accepting new patients

Locations

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: ehaughney342091@nyumc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1215400627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013987",
            "telephone_number": "516-663-0333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Taylor Ave",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "NY",
            "postal_code": "117565609",
            "country_code": "US",
            "telephone_number": "516-579-4506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGHNEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehaughney342091@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.