Individual provider Active NPI

Kristine Nicole Hauf, PA-C

  • Surgical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1053510172
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C03550 Issued in MD
Practice address
2401 W Belvedere Ave
Neuroscience House Officer Office
Baltimore, MD 21215-5216
Phone
(410) 601-1544
Fax
(410) 601-1543
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C03550 MD
Medical Physician Assistant 363AM0700X C03550 MD
Surgical Physician Assistant 363AS0400X C03550 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Neuroscience House Officer Office
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Attn: Credentialing
Baltimore, MD 21215-5216
Phone (410) 601-5524

Other names 1

  • Ms. Kristine Nicole Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080103000501 MD Practitioner - Physician Assistant 3274613203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Orthopedic Specialists LLCGroup PAC ID 4082928098, 46 clinicians

Practice addresses (Care Compare)

5415 Old Court Rd
Randallstown, MD 21133-5170
Phone (410) 701-4437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C03550MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Aug 20, 2007 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Aug 20, 2007 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2401 W Belvedere Ave
Ofc
Baltimore, MD 21215
Phone (410) 601-1544

2401 W Belvedere Ave
Ofc Off
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5051 Greenspring Ave
Ste 300
Baltimore, MD 21209
Phone (410) 601-1900

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1053510172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "ATTN: CREDENTIALING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5524",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "NEUROSCIENCE HOUSE OFFICER OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-1544",
            "fax_number": "410-601-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUF",
        "first_name": "KRISTINE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03550",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C03550",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C03550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MILLER",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.