Individual provider Active NPI

Steven J Heneghan, M.D.

  • Surgery Physician
  • Elmira, NY
National Provider Identifier
1801861968
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
172313 Issued in NY
Practice address
600 Roe Ave
Elmira, NY 14905-1629
Phone
(607) 734-2695
Fax
(607) 734-2917
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 172313 NY Primary
Surgical Critical Care Physician 2086S0102X 172313 NY

Addresses

Primary practice location

600 Roe Ave
Elmira, NY 14905-1629

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
01266619MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000486 NY Practitioner - General Surgery 5597807222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
172313NYMDSurgical Critical Care Physician

Interoperability endpoints

  • Direct secure messaging: sheneghan20610@direct.xtensys.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1801861968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050",
            "fax_number": "607-873-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051629",
            "telephone_number": "607-734-2695",
            "fax_number": "607-734-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEGHAN",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "172313",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "172313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01266619",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.