Organization Active NPI

Stephanie Buck-Haskin MD PC

  • Legal Medicine
  • Great Neck, NY
National Provider Identifier
1487937702
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
150662 Issued in NY
Legal business name
STEPHANIE BUCK-HASKIN MD PC
Practice address
600 Northern Blvd
109
Great Neck, NY 11021-5206
Phone
(516) 482-6100
Fax
(516) 466-7616
NPI assigned
Sep 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Stephanie C. Buck-Haskin, M.D.NPI 1952362774
Title
President
Phone
(516) 482-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 150662 NY Primary

Addresses

Primary practice location

600 Northern Blvd
109
Great Neck, NY 11021-5206

Mailing address

600 Northern Blvd
109
Great Neck, NY 11021-5206
Phone (516) 482-6100

Other identifiers 1

IdentifierTypeStateIssuer
1952362774OtherNYNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000259 NY Part B Supplier - Clinic/Group Practice 8325203367 Receives reassigned benefits from 1 practitioner
Practice locations: Rego Park, NY; New Hyde Park, NY; Great Neck, NY; Forest Hills, NY; Elmhurst, NY; Levittown, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0934602Stephanie Buck Haskin MD PC600 Northern Blvd Suite 109, Great Neck, NY 11021Provider-performed microscopyOct 1, 2026

National Provider Directory

National Provider Directory

Locations

4008 Forley St
Ste 3
Elmhurst, NY 11373

200 Garden City Plz
#100B
Garden City, NY 11530

600 Northern Blvd
Ste 109
Great Neck, NY 11021
Phone (516) 482-6100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1487937702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "address_2": "109",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215206",
            "telephone_number": "516-482-6100",
            "fax_number": "516-466-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD",
            "address_2": "109",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215206",
            "telephone_number": "516-482-6100",
            "fax_number": "516-466-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE BUCK-HASKIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-22",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "BUCK-HASKIN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-482-6100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "150662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952362774",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.