Brooklyne Hazenberg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA62332 Issued in CA

Practice address

4171 Oceanside Blvd Ste 109
Oceanside, CA 92056-6008

Phone

(760) 216-6253

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medhero San Clemente a Professional Medical CorporationGroup PAC ID 3971809740, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brooklyne.hazenberg@4294.securemail.prognocis.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medhero San Clemente, a Professional Medical Corporation

  • Urgent Care Clinic/Center
  • San Clemente, CA
  • NPI 1558736520
  Medicare reassignment Care Compare group
• Jurkowski Medical Corporation

  dba MD Today Urgent Care

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1750644258
  Medicare reassignment
• Two Zeds Medical Corporation

  dba MD Today Urgent Care

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1275909434
  Medicare reassignment
• Next Step Medical Inc.

  dba 828 Urgent Care

  • Urgent Care Clinic/Center
  • Oceanside, CA
  • NPI 1164730404
  NPD
• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748
  NPD (past)

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685232000000",
    "number": "1104524891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31775 NE WILSONVILLE RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327089",
            "telephone_number": "503-899-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4171 OCEANSIDE BLVD STE 109",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920566008",
            "telephone_number": "760-216-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZENBERG",
        "first_name": "BROOKLYNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-05-28",
        "certification_date": "2023-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan F Hawkins, D.O
• Jennifer Novak Hawkins, PT
• Latoya Hayes, RD
• Michelle L Hayton, OCCUPATIONAL THERAPY
• Sally Hazard, LMFT
• Lanay Hazzard-Marcell
• Health Link Medical Group Inc
• Health Link Medical Management Services LLC
• Health Psychology Center, P.C.
• Health-Link Medical Center

• Physician Assistant in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2023; 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.