Individual provider Active NPI

David I Hauer, MD

  • Family Medicine Physician
  • Lake Ronkonkoma, NY
National Provider Identifier
1518969880
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
141661 Issued in NY
Practice address
388 Hawkins Ave
Ste 1
Lake Ronkonkoma, NY 11779-4280
Phone
(631) 588-8460
Fax
(631) 588-8480
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 141661 NY Primary

Addresses

Primary practice location

388 Hawkins Ave
Ste 1
Lake Ronkonkoma, NY 11779-4280

Mailing address

388 Hawkins Ave
Ste 1
Lake Ronkonkoma, NY 11779-4280
Phone (631) 588-8460

Other identifiers 1

IdentifierTypeStateIssuer
00693036MedicaidNY

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
I20100218000750 NY Practitioner - Family Practice 2860536547 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141661NYMDFamily Medicine Physician

Organizations & group practices 1

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1518969880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 HAWKINS AVE",
            "address_2": "STE 1",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794280",
            "telephone_number": "631-588-8460",
            "fax_number": "631-588-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 HAWKINS AVE",
            "address_2": "STE 1",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794280",
            "telephone_number": "631-588-8460",
            "fax_number": "631-588-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUER",
        "first_name": "DAVID",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "141661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00693036",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.