Individual provider Active NPI

David B Hammack, MD

  • Diagnostic Radiology Physician
  • Plattsburgh, NY
National Provider Identifier
1720045305
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1158201 Issued in NY
Practice address
762 Route 3
Suite 14
Plattsburgh, NY 12901-7472
Phone
(518) 562-3204
Fax
(518) 563-0707
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1158201 NY Primary

Addresses

Primary practice location

762 Route 3
Suite 14
Plattsburgh, NY 12901-7472

Mailing address

11 Lexington Ave
Plattsburgh, NY 12901-2513
Phone (518) 563-6834

Other identifiers 1

IdentifierTypeStateIssuer
00420562MedicaidNY

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
115820NYMDSocial Worker
1158201NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Radiology of Plattsburgh Ny PC Diagnostic Radiology Past Accepting new patients
Valcour Imaging LLC 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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1720045305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LEXINGTON AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012513",
            "telephone_number": "518-563-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 ROUTE 3",
            "address_2": "SUITE 14",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129017472",
            "telephone_number": "518-562-3204",
            "fax_number": "518-563-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMACK",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1158201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00420562",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.