Alexandra Halitsky, MD
Individual provider Active NPI Pediatrics Physician · Hampton Bays, NY
NPI 1962589960 · NPPES record last updated Oct 28, 2015
Key facts
- NPI
- 1962589960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 221619 (NY)
- Practice address
- 5 Squiretown Rd
Hampton Bays, NY 11946 - Phone
- (631) 728-5300
- Fax
- (631) 728-5360
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160701000772 | NY | Practitioner - Pediatric Medicine | 2668764184 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221619 | NY | MD | Internal Medicine Physician |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 221619 | NY | Yes |
Addresses
Primary practice location
5 Squiretown Rd
Hampton Bays, NY 11946
Mailing address
45 Research Way
Stony Brook Children'S Services, Ufpc
East Setauket, NY 11733
Phone (631) 675-2125
Other providers in Hampton Bays, NY
- Esther Gralnick
- Harvey Gralnick
- Brittany Grube
- Heath Gutterman
- Charles Haddad
- Christopher Halucha
- Linda Hamilton
- Hampton Allergy and Asthma, PLLC
- Hampton Bays Chiroprctic Dr Gerald Piering Gen PTR
- Hampton Bays Dental Associates P.C.
All providers in Hampton Bays, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.