Individual provider Active NPI

Elias Hazzi, MD

  • Medical Oncology Physician
  • Jackson, MI
National Provider Identifier
1164418042
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
35243 Issued in IA
Practice address
1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850
Phone
(517) 205-1594
Fax
(641) 226-5024
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 35243 IA Primary

Addresses

Primary practice location

1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850

Mailing address

1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850
Phone (517) 205-1594

Other identifiers 5

IdentifierTypeStateIssuer
1418582MedicaidIA
35243OtherIAMEDICAL LICENSE
P00121777OtherIARR MEDICARE CV
0418582MedicaidIA
P00161383OtherIARR MEDICARE ONC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehazzi452936@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000473 MI Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5698663813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 E Michigan Ave
Jackson, MI 49201-1850
Phone (517) 205-1594

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
W. a. Foote Memorial Hospital, Inc CurrentSince Sep 1, 2010 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 1, 2010 Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1100 E Michigan Ave
Ste 307
Jackson, MI 49201
Phone (517) 205-1594

1100 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7605

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

Organizations & group practices 3

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 3

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1164418042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 307",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011850",
            "telephone_number": "517-205-1594",
            "fax_number": "517-205-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 307",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011850",
            "telephone_number": "517-205-1594",
            "fax_number": "641-226-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZZI",
        "first_name": "ELIAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IA",
            "license": "35243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1418582",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "35243",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE CV",
            "identifier": "P00121777",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418582",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ONC",
            "identifier": "P00161383",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehazzi452936@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "1100 E Michigan Ave Ste 307",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.