NPIMap

Individual provider Active NPI

John Mackenzie Haines, M.D.

  • Vascular & Interventional Radiology Physician
  • Syracuse, NY
National Provider Identifier
1669793121
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
318238 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(410) 218-7085
NPI assigned
Jun 18, 2010
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 318238 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Syracuse, NY 13210-1834
Phone (410) 218-7085

Other practice location 1

75 Beekman St
Plattsburgh, NY 12901-1427
Phone (518) 561-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220923001118 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 4082987896 Reassigns benefits to 6 organizations
I20240415002708 VT Practitioner - Interventional Radiology 4082987896 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Maryland School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, shared by 4 NPIs, 88 clinicians
Elizabethtown Community HospitalGroup PAC ID 3577554138, shared by 3 NPIs, 62 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243
Phone (518) 481-2545

548 Ridgefield Rd
Shelburne, VT 05482-6312
Phone (802) 318-5740

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

75 Park St
Elizabethtown, NY 12932-2300
Phone (518) 673-6377

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318238NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc Surgery CurrentSince Mar 5, 2024 Accepting new patients
Elizabethtown Community Hospital CurrentSince Mar 5, 2024 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center Surgery CurrentSince Jun 22, 2023 Accepting new patients
Porter Hospital, Inc Surgery CurrentSince Mar 5, 2024 Accepting new patients
University Radiology Associates, LLP Vascular & Interventional Radiology CurrentSince Aug 1, 2022 Accepting new patients
Elizabethtown Community Hospital Current Accepting new patients
Alice Hyde Medical Center Surgery CurrentSince Mar 5, 2024 Accepting new patients
University of Vermont Medical Center Inc Surgery CurrentSince Mar 5, 2024 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Porter Hospital Inc Current Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

224 Harrison St
Ste 601
Syracuse, NY 13202
Phone (315) 464-6672

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

116 Porter Dr
Middlebury, VT 05753
Phone (802) 388-6326

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: jhaines547102@direct.uvmhealth.org

Organizations & group practices 11

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 7

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1669793121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101834",
            "telephone_number": "410-218-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "410-218-7085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011427",
            "country_code": "US",
            "telephone_number": "518-561-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAINES",
        "first_name": "JOHN",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "318238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.