Individual provider Active NPI

Michael Koichi Hasegawa, M.D.

  • Emergency Medicine Physician
  • West Lake Hills, TX
National Provider Identifier
1154761971
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q6753 Issued in TX
Practice address
5100 Bee Caves Rd
West Lake Hills, TX 78746-5221
Phone
(512) 524-7783
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125063470 IL
Emergency Medicine Physician 207P00000X Q6753 TX Primary

Addresses

Primary practice location

5100 Bee Caves Rd
West Lake Hills, TX 78746-5221

Mailing address

5100 Bee Caves Rd
West Lake Hills, TX 78746-5221
Phone (512) 524-7783

Other practice location 1

800 W Central Texas Expy
Killeen, TX 76541-2565
Phone (254) 220-4117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125063470ILMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1154761971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BEE CAVES RD",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465221",
            "telephone_number": "512-524-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BEE CAVES RD",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465221",
            "telephone_number": "512-524-7783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Central Texas Expy",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765412565",
            "country_code": "US",
            "telephone_number": "254-220-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASEGAWA",
        "first_name": "MICHAEL",
        "middle_name": "KOICHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125063470",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q6753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.