Individual provider Active NPI

Douglas James Whikehart, MD

  • Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1386706372
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
202120 Issued in NY
Practice address
375 Seguine Ave
Staten Island, NY 10309-3932
Phone
(718) 226-2274
Fax
(718) 226-2658
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 202120 NY Primary

Addresses

Primary practice location

375 Seguine Ave
Staten Island, NY 10309-3932

Mailing address

27 Ridge Rd
Croton on Hudson, NY 10520-2623

Other identifiers 1

IdentifierTypeStateIssuer
01426053MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001461 NY Practitioner - Psychiatry 5092796185 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Indiana University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202120NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Yonkers CurrentSince Feb 20, 2018 Accepting new patients
St.Vincent' Hospital Westchester Psych CurrentSince Feb 20, 2018 Accepting new patients
St. Joseph'S Hospital Yonkers Current Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Oct 1, 2021 Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: dwhikehart68312@northwell.direct-ci.com

Organizations & group practices 5

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1386706372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RIDGE RD",
            "city": "CROTON ON HUDSON",
            "state": "NY",
            "postal_code": "105202623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SEGUINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093932",
            "telephone_number": "718-226-2274",
            "fax_number": "718-226-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIKEHART",
        "first_name": "DOUGLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "202120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01426053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.