Individual provider Active NPI

Sandra V Hazra, MD

  • Hematology & Oncology Physician
  • Wadsworth, OH
National Provider Identifier
1215972195
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35044095 Issued in OH
Practice address
5133 Ridge Rd Ste 5
Seidman Cancer Ctr
Wadsworth, OH 44281-8078
Phone
(440) 844-3951
Fax
(440) 722-8396
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD175021 OR
Hematology & Oncology Physician 207RH0003X 35044095 OH Primary

Addresses

Primary practice location

5133 Ridge Rd Ste 5
Seidman Cancer Ctr
Wadsworth, OH 44281-8078

Mailing address

24701 Euclid Ave
Third Floor Billing Services
Euclid, OH 44117-1714
Phone (440) 844-3951

Other identifiers 3

IdentifierTypeStateIssuer
0423581MedicaidOH
341660197AOtherSUMMACARE
000000134345OtherOHANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, OR2 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
I20040115000364 OH Practitioner - Hematology/Oncology 3577464346 Reassigns benefits to 2 organizations
I20170425000080 OR Practitioner - Internal Medicine 3577464346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

139 Garau St
Bluffton, OH 45817-1027
Phone (419) 358-9010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35044095OHMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Mar 8, 2017 Accepting new patients
Bend Memorial Clinic PC Hematology & Oncology Current Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Dec 19, 2022 Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Dec 19, 2022 Accepting new patients
Blanchard Valley Regional Health Center Current Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Mar 8, 2017 Accepting new patients
Bend Memorial Clinic PC CurrentSince Oct 25, 2021 Accepting new patients
The Metrohealth System Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
University Hospitals Regional Practices LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

139 Garau St
Bluffton, OH 45817
Phone (419) 358-9010

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

15990 Medical Dr S
Findlay, OH 45840
Phone (419) 422-9898

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2610 Uhrmann Rd
Klamath Falls, OR 97601
Phone (541) 274-4171

2865 Daggett Ave
Ofc
Klamath Falls, OR 97601

Interoperability endpoints

  • Direct secure messaging: shazra18639@directmsg.bmctotalcare.com
  • Direct secure messaging: shazra242880@direct.metrohealth.org
  • Direct secure messaging: sandrahazra@uhhs.allscriptsdirect.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1215972195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "THIRD FLOOR BILLING SERVICES",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "440-844-3951",
            "fax_number": "440-722-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5133 RIDGE RD STE 5",
            "address_2": "SEIDMAN CANCER CTR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818078",
            "telephone_number": "440-844-3951",
            "fax_number": "440-722-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZRA",
        "first_name": "SANDRA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OR",
            "license": "MD175021",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35044095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0423581",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "341660197A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000134345",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.