Individual provider Active NPI

Kenneth S Hazlett, M.D.

  • Diagnostic Radiology Physician
  • Cocoa Beach, FL
National Provider Identifier
1023026945
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME70170 Issued in FL
Practice address
701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone
(321) 799-7111
Fax
(770) 237-4866
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X ME70170 FL
Nuclear Radiology Physician 2085N0904X ME70170 FL
Pediatric Radiology Physician 2085P0229X ME70170 FL
Diagnostic Radiology Physician 2085R0202X ME70170 FL Primary
Vascular & Interventional Radiology Physician 2085R0204X ME70170 FL
Diagnostic Ultrasound Physician 2085U0001X ME70170 FL

Addresses

Primary practice location

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585

Mailing address

PO Box 2400
Melbourne, FL 32902-2400
Phone (866) 744-1461

Other identifiers 3

IdentifierTypeStateIssuer
43699OtherFLBCBS
300137407OtherMEDICARE RR
254743100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080529000816 FL Practitioner - Diagnostic Radiology 5496825762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1223 Gateway Dr
Melbourne, FL 32901-2607
Phone (321) 725-4500

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8000

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone (321) 799-7111

8731 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9000

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME70170FLMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Aug 1, 2015 Accepting new patients
Brevard Physician Associates, PLLC Body Imaging CurrentSince Oct 1, 2013 Accepting new patients
Health First Medical Group, LLC Diagnostic Radiology CurrentSince Aug 1, 2015 Accepting new patients
Healthcare America Medical Group, Inc. Past Accepting new patients

Locations

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

730 Malabar Rd
Malabar, FL 32950
Phone (321) 409-6800

1223 Gateway Dr
Melbourne, FL 32901
Phone (321) 549-0677

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1425 Malabar Rd NE
Palm Bay, FL 32907
Phone (321) 434-8000

490 N Washington Ave
Titusville, FL 32796
Phone 32126842003506

8725 N Wickham Rd
Viera, FL 32940
Phone (321) 253-4673

Interoperability endpoints

  • Direct secure messaging: khazlett71742@epicdirect.hf.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 5

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1023026945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329022400",
            "telephone_number": "866-744-1461",
            "fax_number": "770-621-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313585",
            "telephone_number": "321-799-7111",
            "fax_number": "770-237-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLETT",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "ME70170",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "FL",
            "license": "ME70170",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME70170",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME70170",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME70170",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "ME70170",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43699",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "300137407",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254743100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.