Active NPI
Michael Haggerty, PA-C
- Surgical Physician Assistant
- New York, NY
National Provider Identifier
1255112959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 030811-01
- Practice address
- 535 E 70TH St
New York, NY 10021-4898 - Phone
- (212) 606-1000
- NPI assigned
- Oct 9, 2023
- Last updated
- Oct 9, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 030811-01 | NY | Primary |
Addresses
Primary practice location
535 E 70TH St
New York, NY 10021-4898
Mailing address
78 Cardinal LN
Hauppauge, NY 11788-2118
Phone (631) 609-7523
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
| License | State | Type | Specialty |
|---|---|---|---|
| 030811-01 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1255112959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 CARDINAL LN",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117882118",
"telephone_number": "631-609-7523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214898",
"telephone_number": "212-606-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGGERTY",
"first_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-09",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "030811-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.