Active NPI
Elliot Haber
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1386060051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 057923
- Practice address
- 1918 Homecrest Ave
Brooklyn, NY 11229-2710 - Phone
- (718) 200-5175
- NPI assigned
- Mar 5, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 057923 | NY | Primary |
Addresses
Primary practice location
1918 Homecrest Ave
Brooklyn, NY 11229-2710
Mailing address
1918 Homecrest Ave
Brooklyn, NY 11229-2710
Phone (718) 200-5175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20160527000507 | NY | Order and Referring Only - Dentist | 6103116413 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- elliot.haber.p1@direct.ezramedical.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469577600000",
"number": "1386060051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1918 HOMECREST AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112292710",
"telephone_number": "718-200-5175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1918 HOMECREST AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112292710",
"telephone_number": "718-200-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABER",
"first_name": "ELLIOT",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-05",
"last_updated": "2016-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "057923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.