NPIMap

Individual provider Active NPI

Douglas L Haas, D.O.

  • Family Medicine Physician
  • Dolgeville, NY
National Provider Identifier
1679674907
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
174706-1 Issued in NY
Practice address
30 S Main St
Dolgeville, NY 13329-1318
Phone
(315) 429-8065
Fax
(315) 429-3195
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 174706-1 NY Primary

Addresses

Primary practice location

30 S Main St
Dolgeville, NY 13329-1318

Mailing address

30 S Main St
Dolgeville, NY 13329-1318
Phone (315) 429-8065

Other identifiers 5

IdentifierTypeStateIssuer
085224OtherNYMOHAWK VALLEY PHYSICANS
01108236MedicaidNY
040403006407OtherNYFIDELIS
16-1339507OtherNYTAX ID #
174706-1OtherNYSTATE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100212000023 NY Practitioner - Family Practice 8123161213 Reassigns benefits to 1 organization
Practice locations: Dolgeville, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc Fulton County ChapterGroup PAC ID 5890717979, 27 clinicians

Practice addresses (Care Compare)

30 S Main St
Dolgeville, NY 13329-1318
Phone (315) 429-8065

465 N Perry St
Johnstown, NY 12095-1014
Phone (518) 736-3937

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174706-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Dimensions in Living Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: haasd@lexclinic.medentdirect.com

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.

Hospital & facility affiliations 9

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1679674907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S MAIN ST",
            "city": "DOLGEVILLE",
            "state": "NY",
            "postal_code": "133291318",
            "telephone_number": "315-429-8065",
            "fax_number": "315-429-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S MAIN ST",
            "city": "DOLGEVILLE",
            "state": "NY",
            "postal_code": "133291318",
            "telephone_number": "315-429-8065",
            "fax_number": "315-429-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "DOUGLAS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "174706-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHAWK VALLEY PHYSICANS",
            "identifier": "085224",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01108236",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040403006407",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "16-1339507",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "174706-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dolgeville, NY

Sources for this page

Verify at the official NPI Registry.