Jonathan A Harris, MD
Individual provider Active NPI Family Medicine Physician · Endwell, NY
NPI 1376563551 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376563551
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 124091 (NY)
- Practice address
- 415 Hooper Rd
Endwell Family Physicians LLP
Endwell, NY 13760-3698 - Phone
- (607) 754-3863
- Fax
- (607) 754-5697
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- New York University School of Medicine, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Endwell Family Physicians LLP
Practice addresses (Care Compare)
415 Hooper Rd
Endwell, NY 13760-3646
Phone (607) 754-3863
Hospital & facility affiliations
- United Health Services Hospitals, Inc
- Our Lady of Lourdes Memorial Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.22 of 100
- Quality
- 78.62
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 68.76
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 13 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
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 |
|---|---|---|---|---|
| I20100112000343 | NY | Practitioner - Family Practice | 5496659856 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124091 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of Lourdes Memorial Hospital Inc. | Current |
Accepting new patients | |
| Endwell Family Physicians LLP | Family Medicine | Current | Accepting new patients |
| Our Lady of Lourdes Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Endwell Family Physicians LLP | Family Medicine | Current |
Accepting new patients |
| United Health Services Hospitals, Inc. | Current |
Accepting new patients |
Locations
169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111
169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701
415 Hooper Rd
Endwell, NY 13760
Phone (607) 754-3863
Interoperability endpoints
- jharris@efp.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 124091 | NY | Yes |
Addresses
Primary practice location
415 Hooper Rd
Endwell Family Physicians LLP
Endwell, NY 13760-3698
Mailing address
415 Hooper Rd
Endwell, NY 13760-3698
Phone (607) 754-3863
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00557617 | Medicaid | NY | |
| 10031687 | Other | CDPHP | |
| NY0024397 | Other | CHAMPUS | |
| 3480 | Other | BLUEPOINT | |
| 58141 | Other | GHI HMO | |
| 3480 | Other | HMO BLUE | |
| 3480 | Other | BSCNY | |
| 4210330 | Other | AETNA | |
| 9684882 | Other | GHI | |
| 320946 | Other | MVP | |
| 3480 | Other | EMPIRE BS | |
| 3480 | Other | EXCELLUS | |
| 320946 | Other | MVP SELECT | |
| 878442 | Other | AETNA HMO |
Other providers in Endwell, NY
- Karen J Guillon
- Kaitlyn Marie Gustafson
- Hanger Medical LLC
- Maryellen Hanley
- Iesa Marie Harrigan
- Sally Hartwick
- Patrizia Haus
- Courtney Lynn Hayes
- Shannon Hickling
- James C Holler
All providers in Endwell, NY · Family Medicine 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 8, 2007. 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.