Active NPI
Gregory Jerome Haskin, D.D.S.
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1568444057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 039964-1
- Practice address
- 4571 Kings Hwy
Brooklyn, NY 11234-2025 - Phone
- (718) 692-4791
- Fax
- (718) 692-3362
- NPI assigned
- Nov 18, 2005
- Last updated
- May 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 039964-1 | NY | Primary |
Addresses
Primary practice location
4571 Kings Hwy
Brooklyn, NY 11234-2025
Mailing address
4571 Kings Hwy
Brooklyn, NY 11234-2025
Phone (718) 692-4791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 949106 | Medicaid | NY |
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 |
|---|---|---|---|---|
| I20151014001185 | NY | Order and Referring Only - Dentist | 4587973508 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039964-1 | NY | MD | General Practice Dentistry |
| 039964 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gregory J Haskin DDS PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1568444057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4571 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112342025",
"telephone_number": "718-692-4791",
"fax_number": "718-692-3362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4571 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112342025",
"telephone_number": "718-692-4791",
"fax_number": "718-692-3362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASKIN",
"first_name": "GREGORY",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "039964-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "949106",
"state": "NY"
}
],
"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 May 6, 2008; 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.