Individual provider Active NPI

Michael Haggerty, MD

  • Obstetrics & Gynecology Physician
  • Youngstown, OH
National Provider Identifier
1992808794
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35070508 Issued in OH
Practice address
5533 Mahoning Ave
Suite D
Youngstown, OH 44515-2366
Phone
(330) 793-7966
Fax
(330) 793-8688
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35070508 OH Primary

Addresses

Primary practice location

5533 Mahoning Ave
Suite D
Youngstown, OH 44515-2366

Mailing address

5533 Mahoning Ave
Suite D
Youngstown, OH 44515-2366
Phone (330) 793-7966

Other identifiers 1

IdentifierTypeStateIssuer
0258984MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040602001153 OH Practitioner - Obstetrics/Gynecology 1658353800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northeastern Ohio University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5533 Mahoning Ave
Suite D
Youngstown, OH 44515-2366
Phone (330) 793-7966

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35070508OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael P Haggerty MD LLC Obstetrics & Gynecology CurrentSince May 19, 2003 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients
Douglas S Coslett MD PC Obstetrics & Gynecology Past Accepting new patients
Scranton Quincy Clinic Company LLC Past Accepting new patients

Locations

5533 Mahoning Ave
Ste D
Youngstown, OH 44515
Phone (330) 793-2701

Interoperability endpoints

  • Direct secure messaging: mhaggerty42590@direct.bsmhealth.org

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.

Hospital & facility affiliations 4

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1992808794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE",
            "address_2": "SUITE D",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-793-7966",
            "fax_number": "330-793-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE",
            "address_2": "SUITE D",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-793-7966",
            "fax_number": "330-793-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35070508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0258984",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.