Organization Active NPI

Thomas S. Hastetter MD LLC

Doing business as Evansville OBGYN

  • Obstetrics & Gynecology Physician
  • Evansville, IN
National Provider Identifier
1114059839
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
THOMAS S. HASTETTER MD LLC
Doing business as
Evansville OBGYN
Practice address
7145 E Virginia St
Evansville, IN 47715
Phone
(812) 477-7111
Fax
(812) 477-7117
NPI assigned
Mar 9, 2007
Last updated
Apr 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Lisa K Hastetter
Title
Administrator
Phone
(812) 476-6161

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

7145 E Virginia St
Evansville, IN 47715

Mailing address

7145 E Virginia St
Suite 2000
Evansville, IN 47715-9144
Phone (812) 962-7890

Other identifiers 1

IdentifierTypeStateIssuer
1001807AMedicaidIN

Other names 1

  • Evansville OBGYN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070516000474 IN Part B Supplier - Clinic/Group Practice 7416054069 Receives reassigned benefits from 1 practitioner
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory
Tax ID family
Evansville OBGYN2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4199 Gateway Blvd
#2000
Newburgh, IN 47630
Phone (812) 858-2229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1114059839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 E VIRGINIA ST",
            "address_2": "SUITE 2000",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159144",
            "telephone_number": "812-962-7890",
            "fax_number": "812-476-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7145 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47715",
            "telephone_number": "812-477-7111",
            "fax_number": "812-477-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS S. HASTETTER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "HASTETTER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "812-476-6161"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001807A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evansville OBGYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evansville OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.