Michael D Hazelberg, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50451-21 Issued in WI

Practice address

2514 S 102ND St Ste 160
West Allis, WI 53227-2142

Phone

(414) 255-0300

Fax

(414) 543-9601

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Group Health Cooperative of South Central Wisconsin

  • Health Maintenance Organization
  • Madison, WI
  • NPI 1245260165
  NPD
• Iah of Wisconsin, PLLC

  • Family Medicine Physician
  • Brookfield, WI
  • NPI 1861898090
  NPD
• Vpa PC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Brookfield, WI
  • NPI 1376871947

  Family Medicine

  NPD
• Vpa PC

  • Family Medicine Physician
  • Brookfield, WI
  • NPI 1659484657
  NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD
• Holy Family Memorial Inc

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1013051069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST STE 160",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST STE 160",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-255-0300",
            "fax_number": "414-543-9601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 S Mountin Dr",
            "address_purpose": "LOCATION",
            "city": "Mayville",
            "state": "WI",
            "postal_code": "530501498",
            "country_code": "US",
            "telephone_number": "920-387-7500",
            "fax_number": "920-387-7596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 S Mountin Dr",
            "address_purpose": "LOCATION",
            "city": "Mayville",
            "state": "WI",
            "postal_code": "530501498",
            "country_code": "US",
            "telephone_number": "920-387-7500",
            "fax_number": "920-387-7596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZELBERG",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50451-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn K Havens, MD
• Ericka Hawke
• Lori M Haymon
• Nicholas Paul Hayon
• Kimberly R Hays
• Hear Wisconsin, Inc.
• Cynthia Heck, REGISTERED NURSE
• Samantha Hedican
• Jessica Heinlein, MOTR/L
• Maria Lynn Heintz

• Family Medicine Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.