Individual provider Active NPI

Kim Haberer, MD

  • Pediatric Cardiology Physician
  • Bronx, NY
National Provider Identifier
1306254594
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
131827 Issued in CA
Practice address
3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone
(718) 741-2387
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 131827 CA Primary

Addresses

Primary practice location

3415 Bainbridge Ave
Bronx, NY 10467-2403

Mailing address

8440 112 St NW,
Edmonton, ALBERTA T6G 2B7
CA

Other practice location 1

505 Parnassus Ave
Moffitt Room 1235, Box 0544
San Francisco, CA 94143-0544
Phone (415) 476-1802

Other practice location 2

8440n 112 St NW
Edmonton, Alberta T6G 2B7
CA
Phone (647) 640-0443

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
I20210729000192 NY Practitioner - Pediatric Medicine 7113210493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Hicksville Rd
Bethpage, NY 11714-3471

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 20, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 17, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Apr 20, 2021 Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: khaberer67662@northwell.direct-ci.com
  • Direct secure messaging: khaberer1677469@nychhc.direct-ci.com

Organizations & group practices 5

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1306254594",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "8440 112 ST NW,",
            "city": "EDMONTON",
            "state": "ALBERTA",
            "postal_code": "T6G 2B7"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-741-2387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_2": "Moffitt Room 1235, Box 0544",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941430544",
            "country_code": "US",
            "telephone_number": "415-476-1802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8440n 112 St NW",
            "address_purpose": "LOCATION",
            "city": "Edmonton",
            "state": "Alberta",
            "postal_code": "T6G 2B7",
            "country_code": "CA",
            "telephone_number": "647-640-0443",
            "country_name": "Canada",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "HABERER",
        "first_name": "KIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "131827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.