NPIMap

Individual provider Active NPI

Timothy Haydock, MD

  • Emergency Medicine Physician
  • Mount Kisco, NY
National Provider Identifier
1609843705
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
139961 Issued in NY
Practice address
400 E Main St
Northern Westchester Hospital - Emergency Department
Mount Kisco, NY 10549-3417
Phone
(914) 666-1254
Fax
(914) 666-1931
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 139961 NY Primary

Addresses

Primary practice location

400 E Main St
Northern Westchester Hospital - Emergency Department
Mount Kisco, NY 10549-3417

Mailing address

400 E Main St
Northern Westchetser Hospital, Attn Medical Affairs
Mount Kisco, NY 10549-3417
Phone (914) 666-1254

Other identifiers 2

IdentifierTypeStateIssuer
2516230OtherAETNA HMO
4375965OtherAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139961NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester County Health Care Corporation Past Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Organizations & group practices 2

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1609843705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "address_2": "NORTHERN WESTCHETSER HOSPITAL, ATTN MEDICAL AFFAIRS",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1254",
            "fax_number": "914-666-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "address_2": "NORTHERN WESTCHESTER HOSPITAL - EMERGENCY DEPARTMENT",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1254",
            "fax_number": "914-666-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDOCK",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "139961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2516230",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4375965",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.