Justin C Hazen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5400 Issued in AZ

Practice address

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831

Phone

(928) 537-4375

NPI assigned

May 11, 2013

Sex

Male

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 WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1962453860
  Medicare reassignment
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  NPD (past)

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

{
    "created_epoch": "1368230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368230400000",
    "number": "1114363603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "JUSTIN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-11",
        "last_updated": "2013-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estelle Theresa Harrison, LPC
• Sara Hart, LCSW
• Haven of Show Low Alf LLC
• Haven of Show Low, LLC
• Michael S Hayes, DO
• Bradley Marvin Head, LPC
• Health Angels Companion Care, Inc.
• Heart Center of Northeastern Arizona, LLC
• Heart Health Care LLC
• Steven W Helland, M.D.

• Physician Assistant in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.