Individual provider Active NPI

Kent D Haselow, M.D.

  • Anesthesiology Physician
  • Waukesha, WI
National Provider Identifier
1245213784
Registry record updated Feb 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
40947-020 Issued in WI
Practice address
725 American Ave
Waukesha, WI 53188-5031
Phone
(262) 544-2011
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 40947-020 WI Primary

Addresses

Primary practice location

725 American Ave
Waukesha, WI 53188-5031

Mailing address

225 S Executive Dr
Brookfield, WI 53005-4266
Phone (262) 787-4026

Other identifiers 2

IdentifierTypeStateIssuer
32545600MedicaidWI
P00243868OtherRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000679 WI Practitioner - Anesthesiology 7618876137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anex, S.C.Group PAC ID 4486540556, 38 clinicians

Practice addresses (Care Compare)

725 S American Ave
Waukesha, WI 53188-5301
Phone (262) 544-2011

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40947-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anex, S.C. Anesthesiology CurrentSince Oct 1, 2004 Accepting new patients
Bellingham Anesthesia Associates, P.S. Anesthesiology PastSince Aug 1, 2008 Accepting new patients
Providence Wa Anesthesia Services, P.C. Anesthesiology Past Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

Bin 88836
Milwaukee, WI 53288

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Interoperability endpoints

  • Direct secure messaging: khaselow4139@direct.phci.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234569600000",
    "number": "1245213784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054266",
            "telephone_number": "262-787-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-544-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELOW",
        "first_name": "KENT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2009-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "40947-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32545600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00243868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.