Kaitlin Haines, M.D.
Individual provider Active NPI Gynecologic Oncology Physician · Brightwaters, NY
NPI 1306293279 · NPPES record last updated Jul 11, 2023
Key facts
- NPI
- 1306293279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecologic Oncology Physician 207VX0201X
- License
- 304052-01 (NY)
- Practice address
- 404 Potter Blvd
Brightwaters, NY 11718-1830 - Phone
- (631) 376-0055
- Fax
- (631) 376-0099
- NPI assigned
- May 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Gynecological Oncology
- Education
- Tufts University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
404 Potter Blvd
Brightwaters, NY 11718-1830
Phone (631) 376-0055
Hospital & facility affiliations
- Long Island Jewish Medical Center
- NS/Lij HS Southside Hospital
- North Shore University Hospital
- NS/Lij HS Huntington Hospital
- Plainview Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 27 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200827001944 | NY | Practitioner - Gynecological Oncology |
1355621442 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304052-01 | NY | MD | Gynecologic Oncology Physician |
Practice roles (5 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore - Lij Medical PC | Current |
Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients | |
| North Shore-Lij Medical PC | Current |
Accepting new patients | |
| South Shore University Hospital | Past | Accepting new patients |
Locations
440 E Main St
Bay Shore, NY 11706
Phone (631) 414-2023
404 Potter Blvd
Brightwaters, NY 11718
Phone (631) 376-0055
111 E 210th St
Bronx, NY 10467
1948 Deer Park Ave
Fl 1
Deer Park, NY 11729
Phone (631) 337-1099
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
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 H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- kaitlinhaines@nslijmedgr.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Gynecologic Oncology Physician | 207VX0201X | 304052-01 | NY | Yes |
Addresses
Primary practice location
404 Potter Blvd
Brightwaters, NY 11718-1830
Mailing address
404 Potter Blvd
Brightwaters, NY 11718-1830
Phone (631) 376-0055
Other providers in Brightwaters, NY
- Janet B Erickson
- Nicole Lynn Flandina
- Eric C Freeman
- Isabella Rose Giordano
- Nicole Grehn
- Gary Hanson
- Kristen Hayward
- Luanne Horne
- Ekambaram Ilamathi
- Island Gynecologic Oncology, PLLC
All providers in Brightwaters, NY · Gynecologic Oncology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.