Individual provider Active NPI

Clairisse Marcelle Hafey

  • Emergency Medicine Physician
  • Danville, PA
National Provider Identifier
1598394157
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
72848 Issued in CT
Practice address
Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001
Phone
(570) 271-6211
NPI assigned
Apr 6, 2020
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 72848 CT Primary

Addresses

Primary practice location

Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001

Mailing address

66 Main St Apt 604
Yonkers, NY 10701-8853
Phone (860) 866-8683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230714000266 CT Practitioner - Emergency Medicine 8123441458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Connecticut PCGroup PAC ID 8820390214, 30 clinicians

Practice addresses (Care Compare)

50 Hospital Hill Rd
Sharon, CT 06069-2096
Phone (860) 364-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72848CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Connecticut PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

50 Hospital Hill Rd
Sharon, CT 06069
Phone (860) 364-4000

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1598394157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MAIN ST APT 604",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107018853",
            "telephone_number": "860-866-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEY",
        "first_name": "CLAIRISSE",
        "middle_name": "MARCELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "72848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.