NPIMap

Individual provider Active NPI

Mary Katharine Halloran, MD

  • Family Medicine Physician
  • Elizabethtown, NY
National Provider Identifier
1396989059
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60265442 Issued in NY
Practice address
66 Park Street
Elizabethtown, NY 12932
Phone
(518) 873-6377
NPI assigned
Apr 26, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elizabethtown Community Hospital 62 clinicians

Practice addresses (Care Compare)

75 Park St
Elizabethtown, NY 12932-2300
Phone (518) 673-6377

Hospital & facility affiliations

  • HCR / HCR Home Care Chha (Plattsburgh) Home health agency, Plattsburgh, NY, CCN 337024
  • Essex County Nursing Service Home health agency, Elizabethtown, NY, CCN 337118
  • High Peaks Hospice and Palliative Care, Inc Hospice, Hudson Falls, NY, CCN 331531
  • Elizabethtown Community Hospital Hospital, Elizabethtown, NY, CCN 331302
  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Elizabethtown Community Hospital Nursing home, CCN 33Z302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20121108000109 NY Practitioner - Family Practice 8921259557 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60265442NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Community Hospital CurrentSince Jun 21, 2012 Accepting new patients
Elizabethtown Community Hospital CurrentSince Jun 21, 2012 Accepting new patients
Essex Operations Associates LLC Past Accepting new patients
Elizabethtown Community Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mhalloran182658@direct.uvmhealth.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 60265442 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

66 Park Street
Elizabethtown, NY 12932

Mailing address

PO Box 277
Elizabethtown, NY 12932-0277
Phone (518) 873-6377

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 13, 2014.

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1396989059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "129320277",
            "telephone_number": "518-873-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PARK STREET",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "12932",
            "telephone_number": "518-873-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLORAN",
        "first_name": "MARY",
        "middle_name": "KATHARINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-26",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "60265442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NY

Sources for this page

Verify at the official NPI Registry.