Individual provider Active NPI

Matthew Jacob Halloran, FNP-C

  • Family Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1922648419
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347909 Issued in NY
Practice address
4400 Vestal Pkwy E
Binghamton, NY 13902-4400
Phone
(607) 777-4954
NPI assigned
Jan 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 527947 NY
Family Nurse Practitioner 363LF0000X 347909 NY Primary

Addresses

Primary practice location

4400 Vestal Pkwy E
Binghamton, NY 13902-4400

Mailing address

PO Box 23
Callicoon Center, NY 12724-0023
Phone (845) 594-7504

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210928002680 NY Practitioner - Nurse Practitioner 6800293200 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.41 of 100Reported as group
Quality
90.71
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
527947NYMDRegistered Nurse
347909NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Hospital, Inc Current Accepting new patients
Sullivan Emergency Services PC CurrentSince Aug 23, 2021 Accepting new patients
Orange Emergency Services PC CurrentSince May 8, 2023 Accepting new patients
Delaware Valley Hospital, Inc CurrentSince Jan 16, 2023 Accepting new patients

Locations

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

2 Titus Pl
#13202
Walton, NY 13856
Phone (607) 865-2197

2 Titus Pl
Walton, NY 13856
Phone (607) 865-2197

1 Titus Pl
Walton, NY 13856
Phone (607) 337-4700

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.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1922648419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "CALLICOON CENTER",
            "state": "NY",
            "postal_code": "127240023",
            "telephone_number": "845-594-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PKWY E",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139024400",
            "telephone_number": "607-777-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLORAN",
        "first_name": "MATTHEW",
        "middle_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "527947",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.