NPIMap

Individual provider Active NPI

Samantha J Haken, MD

  • Family Medicine Physician
  • Peshawbestown, MI
National Provider Identifier
1154735850
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301105789 Issued in MI
Practice address
2300 N Stallman Road
Suite a
Peshawbestown, MI 49682
Phone
(231) 534-7200
Fax
(231) 534-7460
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301105789 MI Primary

Addresses

Primary practice location

2300 N Stallman Road
Suite a
Peshawbestown, MI 49682

Mailing address

2605 N West Bayshore Drive
Peshawbestown, MI 49682
Phone (231) 534-7750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804000982 MI Practitioner - Family Practice 3870710585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

2325 Rockwell Dr
Midland, MI 48642-9325
Phone (989) 898-9664

555 W Wackerly St
Suite 1600
Midland, MI 48640-4710
Phone (989) 839-8810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Traverse Band of Ottawa and Chippewa Indians CurrentSince Feb 4, 2019 Accepting new patients
DLP Marquette Physician Practices Inc Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Jun 13, 2022 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jul 1, 2014 Accepting new patients
Mymichigan Medical Group Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
Grand Traverse Band of Ottawa and Chippewa Indians PastSince Aug 8, 2021 Accepting new patients
Mymichigan Medical Group Past Accepting new patients

Locations

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

555 W Wackerly St
Ste 1600
Midland, MI 48640
Phone (989) 374-0131

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

5785 E Broadway Rd
Mt Pleasant, MI 48858
Phone (989) 773-9421

2605 N West Bay Shore Dr
Suttons Bay, MI 49682
Phone (231) 271-6006

2300 N Stallman Rd
#A
Suttons Bay, MI 49682
Phone (231) 534-7200

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1154735850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N WEST BAYSHORE DRIVE",
            "city": "PESHAWBESTOWN",
            "state": "MI",
            "postal_code": "49682",
            "telephone_number": "231-534-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N STALLMAN ROAD",
            "address_2": "SUITE A",
            "city": "PESHAWBESTOWN",
            "state": "MI",
            "postal_code": "49682",
            "telephone_number": "231-534-7200",
            "fax_number": "231-534-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKEN",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301105789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peshawbestown, MI

Sources for this page

Verify at the official NPI Registry.