Active NPI
Michael Stephen Haynes, DPM
- Podiatrist
- Agawam, MA
National Provider Identifier
1356389167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1495
- Practice address
- 200 Silver St.
Suite 215
Agawam, MA 01001 - Phone
- (413) 786-7522
- Fax
- (413) 789-1198
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1495 | MA | Primary |
Addresses
Primary practice location
200 Silver St.
Suite 215
Agawam, MA 01001
Mailing address
200 Silver St.
Suite 215
Agawam, MA 01001
Phone (413) 786-7522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060410000377 | MA | Practitioner - Podiatry | 7517976103 | Practice locations: Agawam, MA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1356389167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SILVER ST.",
"address_2": "SUITE 215",
"city": "AGAWAM",
"state": "MA",
"postal_code": "01001",
"telephone_number": "413-786-7522",
"fax_number": "413-789-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SILVER ST.",
"address_2": "SUITE 215",
"city": "AGAWAM",
"state": "MA",
"postal_code": "01001",
"telephone_number": "413-786-7522",
"fax_number": "413-789-1198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "MICHAEL",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MA",
"license": "1495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agawam, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.