Individual provider Active NPI

Christopher J Hasseltine, M.D.

  • Psychiatry Physician
  • Moraine, OH
National Provider Identifier
1205809001
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35075689 Issued in OH
Practice address
5350 Lamme Rd
Moraine, OH 45439-3215
Phone
(937) 534-4620
Fax
(937) 522-8799
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD426412 PA
Psychiatry Physician 2084P0800X K2034 TX
Psychiatry Physician 2084P0800X 35075689 OH Primary

Addresses

Primary practice location

5350 Lamme Rd
Moraine, OH 45439-3215

Mailing address

5350 Lamme Rd
Moraine, OH 45439-3215
Phone (937) 534-4620

Other identifiers 3

IdentifierTypeStateIssuer
101337720MedicaidPA
8K5336OtherTXMEDICARE PTAN
092745F3FOtherPAMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070228000356 TX Practitioner - Psychiatry 5890723746 Reassigns benefits to 2 organizations
I20131025001248 OH Practitioner - Psychiatry 5890723746 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD426412PAMDSpecialist
35075689OHMDPsychiatry Physician
K2034TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Eastway Corporation CurrentSince Sep 16, 2013 Accepting new patients
West Texas Centers for MHMR Psychiatry Past Accepting new patients

Locations

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

9435 Waterstone Blvd
Ste 140
Cincinnati, OH 45249
Phone (513) 613-2977

600 Wayne Ave
Dayton, OH 45410
Phone (937) 396-2525

1400 N Coit Rd
Ste 302
McKinney, TX 75071
Phone (214) 504-3005

Organizations & group practices 4

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1205809001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 LAMME RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454393215",
            "telephone_number": "937-534-4620",
            "fax_number": "937-522-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 LAMME RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454393215",
            "telephone_number": "937-534-4620",
            "fax_number": "937-522-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSELTINE",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD426412",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "K2034",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35075689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101337720",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8K5336",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "092745F3F",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.