Benjamin Hazen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD469663 Issued in MI

Practice address

4020 W Royal Dr
Traverse City, MI 49684-8965

Phone

(231) 421-8099

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  NPD (past)
• Traverse Area Pediatric and Adolescent Clinic PLC

  • Pediatrics Physician
  • Traverse City, MI
  • NPI 1821380031
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1104352129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-421-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-421-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "MD469663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benjamin.hazen@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Lynn Hayes
• Michael Patrick Hayes, PH.D.
• Matthew Eric Hays, PA-C
• Eric Bruce Haywood, BS, CAADC
• Joan Elizabeth Hazelton, LMSW
• Head and Heart Therapeutic Solutions
• Kacie Danielle Heading, LLMSW
• Kodie Heading, M.ED., BCBA, LBA
• Brenton Michael Healan, PHARMACY TECHNICIAN
• Healing Arts Counseling LLC

• Pediatrics Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.