Individual provider Active NPI

Jonathon Thomas Haverty, DO

  • Emergency Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1760987549
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB11428200 Issued in NJ
Practice address
20 Prospect Ave
Hackensack, NJ 07601-1997
Phone
(201) 996-2222
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 309053 NY
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X
Emergency Medicine Physician 207P00000X 25MB11428200 NJ Primary

Addresses

Primary practice location

20 Prospect Ave
Hackensack, NJ 07601-1997

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (201) 996-2222

Other practice location 1

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-0100

Other practice location 2

27005 76th Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210729002831 NY Practitioner - Emergency Medicine 1456754332 Reassigns benefits to 1 organization
I20230209000082 NJ Practitioner - Emergency Medicine 1456754332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-3547

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11428200NJMDEmergency Medicine Physician
309053NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC Multi-Specialty CurrentSince Sep 24, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Multi-Specialty CurrentSince Mar 30, 2024 Accepting new patients
North Shore-Lij Medical PC Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Single Specialty CurrentSince Sep 24, 2022 Accepting new patients
Meridian Medical Group - Specialty Care, PC Multi-Specialty Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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 2

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1760987549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "201-996-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "201-996-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVERTY",
        "first_name": "JONATHON",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "309053",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB11428200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.