Individual provider Active NPI

P William Haake, M.D.

  • Specialist
  • Scottsville, NY
National Provider Identifier
1659494698
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
097375-1 Issued in NY
Practice address
712 Quaker Rd
Scottsville, NY 14546-9635
Phone
(585) 889-1958
Fax
(585) 889-1958
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 097375-1 NY Primary

Addresses

Primary practice location

712 Quaker Rd
Scottsville, NY 14546-9635

Mailing address

712 Quaker Rd
Scottsville, NY 14546-9635
Phone (585) 889-1958

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
097375-1NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659494698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 QUAKER RD",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145469635",
            "telephone_number": "585-889-1958",
            "fax_number": "585-889-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 QUAKER RD",
            "city": "SCOTTSVILLE",
            "state": "NY",
            "postal_code": "145469635",
            "telephone_number": "585-889-1958",
            "fax_number": "585-889-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKE",
        "first_name": "P",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "097375-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.