Individual provider Active NPI

Lance Eliot Hafter, D.O.

  • Emergency Medicine Physician
  • San Angelo, TX
National Provider Identifier
1023075009
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
H2063 Issued in TX
Practice address
120 E Harris Ave
San Angelo, TX 76903-5904
Phone
(325) 747-6741
Fax
(325) 747-8435
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X H2063 TX Primary

Addresses

Primary practice location

120 E Harris Ave
San Angelo, TX 76903-5904

Mailing address

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

Other identifiers 1

IdentifierTypeStateIssuer
8CS002OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060501000655 TX Practitioner - Emergency Medicine 6103836465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H2063TXMDEmergency Medicine Physician
1921OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Apr 1, 2011 Accepting new patients
Shannon Clinic CurrentSince Apr 1, 2011 Accepting new patients
Sterling Emergency Services of Oklahoma, Inc. Emergency Medicine Past Accepting new patients
San Angelo Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

120 E Harris Ave
San Angelo, TX 76903
Phone (325) 653-6741

Interoperability endpoints

  • Direct secure messaging: lhafter6659@shannonhealth.direct-ci.com

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1023075009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904",
            "telephone_number": "325-747-6741",
            "fax_number": "325-747-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904",
            "telephone_number": "325-747-6741",
            "fax_number": "325-747-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFTER",
        "first_name": "LANCE",
        "middle_name": "ELIOT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H2063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CS002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.