Individual provider Active NPI

Haley Marie Thompson, PA-C

  • Physician Assistant
  • Leonardtown, MD
National Provider Identifier
1770064503
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C08530 Issued in MD
Practice address
23000 Moakley St Ste 102
Leonardtown, MD 20650-2916
Phone
(301) 475-5555
Fax
(301) 475-5914
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C08530 MD Primary

Addresses

Primary practice location

23000 Moakley St Ste 102
Leonardtown, MD 20650-2916

Mailing address

23000 Moakley St Ste 102
Leonardtown, MD 20650-2916
Phone (301) 475-5555

Other names 1

  • Haley Marie Squires Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811003680 MD Practitioner - Physician Assistant 6709269574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

23000 Moakley St
Suite 102
Leonardtown, MD 20650-2916
Phone (301) 475-5555

4225 Altamont PL
Suite 101
White Plains, MD 20695-3039
Phone (301) 645-0013

86 Thomas Johnson CT
Frederick, MD 21702-4348
Phone (301) 694-8311

Hospital & facility affiliations

  • Medstar Saint Mary'S Hospital Hospital, Leonardtown, MD, CCN 210028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 11, 2022 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 11, 2022 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

23000 Moakley St
Ste 102
Leonardtown, MD 20650
Phone (301) 475-5555

4225 Altamont Pl
Ste 101
White Plains, MD 20695
Phone (301) 645-0013

Organizations & group practices 4

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 1

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1770064503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST STE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502916",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST STE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502916",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "HALEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C08530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "SQUIRES",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.