Individual provider Active NPI

Patricia Anne Haasis, NNP

  • Neonatal Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1215179858
Registry record updated Oct 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
RN028202 Issued in AZ
Practice address
1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone
(480) 543-2751
NPI assigned
Mar 27, 2009
Last updated
Oct 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X RN028202 AZ Primary

Addresses

Primary practice location

1900 N Higley Rd
Gilbert, AZ 85234-1604

Mailing address

314 E Glencove St
Mesa, AZ 85201-2729
Phone (480) 964-7865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20131007000910 AZ Order and Referring Only - Nurse Practitioner 8921232943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN028202AZMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Phoenix PC Neonatal Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287187200000",
    "number": "1215179858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E GLENCOVE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012729",
            "telephone_number": "480-964-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341604",
            "telephone_number": "480-543-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASIS",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2010-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "RN028202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.