Individual provider Active NPI

Shaina Contigiani Hazen, PA-C

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1245616978
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9273 Issued in GA
Practice address
55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone
(770) 428-0462
Fax
(770) 427-8001
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9108929 FL
Physician Assistant 363A00000X 9273 GA Primary

Addresses

Primary practice location

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156

Mailing address

3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372
Phone (205) 977-1949

Other practice location 1

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Other identifiers 1

IdentifierTypeStateIssuer
0244973-00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SCONTIGIANI432717@DIRECTWELLSTAR.ORG Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191204001630 GA Practitioner - Physician Assistant 1850662941 Reassigns benefits to 1 organization
I20231108003015 AL Practitioner - Physician Assistant 1850662941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9273GAMDGeneral Practice Dentistry
PAT9108929FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jul 10, 2019 Accepting new patients
Anesthesiologists Associated PC CurrentSince Nov 1, 2023 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jul 10, 2019 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 24, 2024 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince May 1, 2024 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 5

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1245616978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR STE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432372",
            "telephone_number": "205-977-1949",
            "fax_number": "205-977-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601156",
            "telephone_number": "770-428-0462",
            "fax_number": "770-427-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Northside Forsyth Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417659",
            "country_code": "US",
            "telephone_number": "770-844-3200",
            "fax_number": "770-844-3655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "SHAINA",
        "middle_name": "CONTIGIANI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108929",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0244973-00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SCONTIGIANI432717@DIRECTWELLSTAR.ORG",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "55 Whitcher St NE Ste 130",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.