Individual provider Active NPI

Jeffrey W. Hazey, MD

  • Surgery Physician
  • Marysville, OH
National Provider Identifier
1164475398
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35065739 Issued in OH
Practice address
140 Colemans Xing
Marysville, OH 43040
Phone
(937) 578-2650
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35065739 OH Primary

Addresses

Primary practice location

140 Colemans Xing
Marysville, OH 43040

Mailing address

140 Colemans Xing
Marysville, OH 43040-7080
Phone (937) 578-2650

Other practice location 1

1800 Zollinger Rd
3rd Floor
Columbus, OH 43221-2849
Phone (614) 293-3230

Other identifiers 1

IdentifierTypeStateIssuer
2164581MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040427000689 OH Practitioner - General Surgery 6002803632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
68.93
Promoting interoperability
100
Improvement activities
40
Cost
75.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065739OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Physician Corporation CurrentSince Sep 18, 2017 Accepting new patients
Union County Physician Corporation Surgery CurrentSince Sep 18, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

140 Colemans Crossing Blvd
Ste 100
Marysville, OH 43040
Phone (937) 578-2650

140 Colemans Crossing Blvd
Marysville, OH 43040
Phone (937) 578-2650

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

1958 E US Highway 36
Ste D
Urbana, OH 43078
Phone (937) 578-2626

Interoperability endpoints

  • Direct secure messaging: jhazey5151@direct.osumc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1164475398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407080",
            "telephone_number": "937-578-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "43040",
            "telephone_number": "937-578-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Zollinger Rd",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432212849",
            "country_code": "US",
            "telephone_number": "614-293-3230",
            "fax_number": "614-293-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZEY",
        "first_name": "JEFFREY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35065739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2164581",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.