Individual provider Active NPI

Henry Madison Haire, MD

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1285799593
Registry record updated Jun 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-15019 Issued in HI
Practice address
670 Glades Rd
400-A
Boca Raton, FL 33431-6461
Phone
(561) 955-5365
Fax
(561) 955-3577
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-15019 HI Primary
Nephrology Physician 207RN0300X ME 28988 FL

Addresses

Primary practice location

670 Glades Rd
400-A
Boca Raton, FL 33431-6461

Mailing address

670 Glades Rd
400-A
Boca Raton, FL 33431-6461
Phone (561) 955-2570

Other identifiers 1

IdentifierTypeStateIssuer
064928700MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 28988FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Pensacola Nephrology, PA Nephrology Past Accepting new patients
Pensacola Nephrology, PA Nephrology Past Accepting new patients

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466208000000",
    "number": "1285799593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "400-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-955-2570",
            "fax_number": "561-955-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "400-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-955-5365",
            "fax_number": "561-955-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRE",
        "first_name": "HENRY",
        "middle_name": "MADISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2016-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-15019",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME 28988",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064928700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.