Individual provider Active NPI

Denise Haberle-Kroog, D.O.

  • Anesthesiology Physician
  • East Patchogue, NY
National Provider Identifier
1881774990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
228990 Issued in NY
Practice address
101 Hospital Rd
East Patchogue, NY 11772-4870
Phone
(631) 475-7680
Fax
(631) 475-7683
NPI assigned
Oct 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 228990 NY Primary

Addresses

Primary practice location

101 Hospital Rd
East Patchogue, NY 11772-4870

Mailing address

250 Patchogue Yaphank Rd
Suite 3
East Patchogue, NY 11772-4800
Phone (631) 475-7680

Other identifiers 1

IdentifierTypeStateIssuer
02442280MedicaidNY

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
I20040426001866 NY Practitioner - Anesthesiology 2062409790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228990NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2024 Accepting new patients
New York University Anesthesiology Current Accepting new patients
Long Island Anesthesia Physicians LLP Anesthesiology CurrentSince Apr 13, 2019 Accepting new patients
New York University Anesthesiology CurrentSince Feb 1, 2024 Accepting new patients
Brookhaven Gastroenterology Associates, P.C. Past Accepting new patients

Locations

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFBACA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881774990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE 3",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724800",
            "telephone_number": "631-475-7680",
            "fax_number": "631-475-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-475-7680",
            "fax_number": "631-475-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERLE-KROOG",
        "first_name": "DENISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "228990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02442280",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.