Bonnie Jean Haberzetle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60317981 Issued in WA

Practice address

5350 Tallman Ave NW Ste 301
Seattle, WA 98107

Phone

(541) 515-2664

Fax

(206) 320-8027

NPI assigned

Oct 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Bonnie Jean Anderson Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center Hospital, Seattle, WA, CCN 500027
• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment Care Compare group NPD
• Grays Harbor County Public Hospital District No 1

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Medicare reassignment
• Grays Harbor County Public Hospital District No. 1

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1811025216
  NPD

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

• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1205162724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 TALLMAN AVE NW STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075902",
            "telephone_number": "206-320-3335",
            "fax_number": "206-320-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 TALLMAN AVE NW STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98107",
            "telephone_number": "541-515-2664",
            "fax_number": "206-320-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERZETLE",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60317981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "258374",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8548190",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "258374",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "ANDERSON",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Ellen Haber, MSW, SWAISC
• Charles M Haberkern, MD
• Rebecca Haberkorn
• Holly M Haberl-Fisher, PT
• Joanne M. Haberman, OT
• Shahid Habib, MD
• Roya Habibi, O.D.
• Jennifer D. Habicht, LMT
• Habla Therapies, LLC
• Annelise Hablutzel

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.