Hazel G Mahatha, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10187-33 Issued in WI

Practice address

1600 Montana Ave
El Paso, TX 79902-5622

Phone

(915) 599-6670

Fax

(915) 775-0549

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Birmingham Medical College, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Mary'S HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
• Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hazel.mahathanp.p1@direct.lifewell.nextgenshare.com
• Direct secure messaging: hmahatha381204@direct-ehr-ssmhc.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.

• St Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment Care Compare group NPD
• St. Mary'S Healthcare

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Amsterdam, NY
  • NPI 1700636347
  NPD
• Lifewell Behavioral Wellness

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1720330194
  NPD (past)
• Oakwood Creative Care Inc.

  • Adult Day Care Clinic/Center
  • Mesa, AZ
  • NPI 1114388626
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nathan Littauer Hospital & Nursing Home

  • General Acute Care Hospital
  • Gloversville, NY
  • NPI 1538296207
  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Pharmacy
  • Gloversville, NY
  • NPI 1285706655

  Hospital

  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Rural Acute Care Hospital
  • Gloversville, NY
  • NPI 1336145168
  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Clinic/Center
  • Gloversville, NY
  • NPI 1770671448

  Hospital

  Care Compare affiliation
• St. Mary'S Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1104248798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 PORTA ROSA CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920495",
            "telephone_number": "907-230-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025622",
            "telephone_number": "915-599-6670",
            "fax_number": "915-775-0549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9565 Diana Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799246951",
            "country_code": "US",
            "telephone_number": "915-887-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2415 E Camelback Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85016",
            "country_code": "US",
            "telephone_number": "602-508-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-4200",
            "fax_number": "920-926-8933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHATHA",
        "first_name": "HAZEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10187-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132207",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10720",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "18267",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9403701",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "10187-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmahatha381204@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hmahatha381204@direct-ehr-ssmhc.com",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Maharlika Resources, Inc
• Sunil Ramesh Mahbubani, M.D.
• Kendra Maher
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• Mainstream Medical PLLC
• Sitratullah Olawunmi Maiyegun, MD

• Psychiatric/Mental Health Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.