Active NPI
Mary Ann Haines, MD
- Family Medicine Physician
- Bronx, NY
National Provider Identifier
1356426480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 247184
- Practice address
- 2300 Westchester Ave
MMG - Bronx East
Bronx, NY 10462-5072 - Phone
- (718) 829-1900
- Fax
- (718) 409-8023
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 247184 | NY | Primary |
Addresses
Primary practice location
2300 Westchester Ave
MMG - Bronx East
Bronx, NY 10462-5072
Mailing address
2300 Westchester Ave
MMG - Bronx East, Urgent Care Center
Bronx, NY 10462-5072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02427347 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 247184 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1659446680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1356426480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 WESTCHESTER AVE",
"address_2": "MMG - BRONX EAST, URGENT CARE CENTER",
"city": "BRONX",
"state": "NY",
"postal_code": "104625072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 WESTCHESTER AVE",
"address_2": "MMG - BRONX EAST",
"city": "BRONX",
"state": "NY",
"postal_code": "104625072",
"telephone_number": "718-829-1900",
"fax_number": "718-409-8023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "MARY ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "247184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02427347",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.