Individual provider Active NPI

Howard Keith Hatfield, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1194942326
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 3629 Issued in FL
Practice address
1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone
(850) 877-4134
Fax
(850) 402-9130
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 3629 FL Primary

Addresses

Primary practice location

1707 Riggins Rd
Tallahassee, FL 32308-5317

Mailing address

1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone (850) 877-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040207000196 FL Practitioner - Physician Assistant 4082507405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

14840 Tamiami TRL
North Port, FL 34287-2701
Phone (941) 564-1542

216 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 296-1313

6890 Belfort Oaks PL
Jacksonville, FL 32216-6241
Phone (904) 296-1313

9905 Old Saint Augustine Rd
Suite 200
Jacksonville, FL 32257-8983
Phone (904) 296-1313

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 3629FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Dec 9, 2024 Accepting new patients

Locations

22371 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 296-1313

9905 Old Saint Augustine Rd
Ste 200
Jacksonville, FL 32257
Phone (904) 296-1313

6890 Belfort Oaks Pl
Jacksonville, FL 32216
Phone (904) 296-1313

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

216 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 296-1313

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Interoperability endpoints

  • Direct secure messaging: khatfield@aquadermatology.emadirect.md

Organizations & group practices 2

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1194942326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "HOWARD",
        "middle_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 3629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.