Kristin Deneille Hazeman, DNP, APRN, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

591 Issued in MN

Practice address

1001 Hart Blvd Ste 100
Monticello, MN 55362-8929

Phone

(763) 295-2921

Fax

(763) 581-9090

NPI assigned

Sep 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kristin Deneille Benson Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stellis Health, PAGroup PAC ID 1153233796, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khazeman831348@direct.centracare.com
• Direct secure messaging: khazeman209239@direct.northmemorial.com

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.

• Stellis Health, PA

  • Multi-Specialty Clinic/Center
  • Buffalo, MN
  • NPI 1184664674
  Medicare reassignment Care Compare group NPD
• Stellis Health, PA

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1013103050
  NPD
• Centracare Health System-NR LLC

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  NPD (past)

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1083228092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19170 JASPER ST NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553039639",
            "telephone_number": "612-867-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HART BLVD STE 100",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628929",
            "telephone_number": "763-295-2921",
            "fax_number": "763-581-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEMAN",
        "first_name": "KRISTIN",
        "middle_name": "DENEILLE",
        "credential": "DNP, APRN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, High-Risk",
            "state": "MN",
            "license": "204419-0",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSING LICENSE",
            "identifier": "204419-0",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE MIDWIFE",
            "identifier": "CNM09522",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "591",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khazeman209239@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khazeman209239@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1700 Highway 25 N",
            "city": "Buffalo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553131930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "BENSON",
            "middle_name": "DENEILLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Advanced Practice Midwife in Monticello, MN
• Providers in Monticello, MN by specialty
• Advanced Practice Midwife in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.