Individual provider Active NPI

Daniel G Hafner, MD

  • Internal Medicine Physician
  • Fishkill, NY
National Provider Identifier
1306817366
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
115129 Issued in NY
Practice address
600 Westage Business Ctr Dr
Fishkill, NY 12524-2281
Phone
(845) 231-5600
Fax
(845) 231-5489
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 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 115129 NY Primary
Emergency Medicine Physician 207P00000X M-1903 GU

Addresses

Primary practice location

600 Westage Business Ctr Dr
Fishkill, NY 12524-2281

Mailing address

PO Box 184
29 Main Street
Hurley, NY 12443-0184
Phone (914) 523-8503

Other identifiers 2

IdentifierTypeStateIssuer
00211541MedicaidNY
H107995OtherGUPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GU2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050223000942 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5698728244 Reassigns benefits to 1 organization
I20160212002502 GU Practitioner - Internal Medicine 5698728244 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115129NYMDSocial Worker
M-1903GUMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Jan 2, 2016 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Guam Memorial Hospital CurrentSince Jan 2, 2016 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Mar 1, 2016 Accepting new patients
Daniel Hafner Physician PC Internal Medicine PastSince Aug 17, 2005 Accepting new patients
Audiology Distribution, LLC PastSince Jan 30, 2013 Accepting new patients
Hearusa Inc Past Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Organizations & group practices 8

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1306817366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 184",
            "address_2": "29 MAIN STREET",
            "city": "HURLEY",
            "state": "NY",
            "postal_code": "124430184",
            "telephone_number": "914-523-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242281",
            "telephone_number": "845-231-5600",
            "fax_number": "845-231-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFNER",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "115129",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "M-1903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211541",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "H107995",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.