Individual provider Active NPI

Honeylee Duque Agustin, M.D.

  • Specialist
  • Ogdensburg, NY
National Provider Identifier
1285918482
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
003924 Issued in NY
Practice address
3 Lyon PL
Ogdensburg, NY 13669-2590
Phone
(315) 713-6770
NPI assigned
Oct 6, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 003924 NY Primary

Addresses

Primary practice location

3 Lyon PL
Ogdensburg, NY 13669-2590

Mailing address

400 N Main St
Warsaw, NY 14569-1025
Phone (585) 786-8940

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
I20180927001566 NY Practitioner - Pediatric Medicine 1658622840 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming County CurrentSince Aug 11, 2018 Accepting new patients
Wyoming County CurrentSince Aug 11, 2018 Accepting new patients
Wyoming County Current Accepting new patients
Wyoming County Current Accepting new patients
Watertown Pediatrics,PC Specialist Past Accepting new patients
Pediatric Wellness of Northern New York Past Accepting new patients

Locations

400 N Main St
Warsaw, NY 14569
Phone (585) 786-1555

Organizations & group practices 6

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285918482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691025",
            "telephone_number": "585-786-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYON PL",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-713-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "HONEYLEE",
        "middle_name": "DUQUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "003924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.