Individual provider Active NPI

Ann Margaret Hajduk-Bennett, DO

  • Pediatrics Physician
  • Commack, NY
National Provider Identifier
1922104744
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
224492 Issued in NY
Practice address
340 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4300
Phone
(631) 864-6440
Fax
(631) 864-6445
NPI assigned
Sep 16, 2006
Last updated
Jun 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 224492 NY Primary

Addresses

Primary practice location

340 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4300

Mailing address

340 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4300
Phone (631) 864-6440

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
I20200828000569 NY Practitioner - Pediatric Medicine 8820415375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224492NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: ahajdukbennett20814@direct.optum.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1922104744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 10",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254300",
            "telephone_number": "631-864-6440",
            "fax_number": "631-864-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 10",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254300",
            "telephone_number": "631-864-6440",
            "fax_number": "631-864-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJDUK-BENNETT",
        "first_name": "ANN",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "224492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.