NPIMap

Individual provider Active NPI

Hazel Jade Milano Tetzlaff, PA-C

  • Physician Assistant
  • Albany, OR
National Provider Identifier
1306494638
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1166933 Issued in NU
Practice address
705 Elm St SW Ste 300
Albany, OR 97321-1958
Phone
(541) 812-4580
NPI assigned
Aug 29, 2019
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1166933 NU Primary

Addresses

Primary practice location

705 Elm St SW Ste 300
Albany, OR 97321-1958

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

2925 Ryan Dr SE
Salem, OR 97301-9687
Phone (503) 399-1262

Other names 1

  • Hazel Jade Milano Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hmilano253907@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191125003015 OR Practitioner - Physician Assistant 7618300047 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

705 Elm St SW
Suite 300
Albany, OR 97321-1958
Phone (541) 812-4580

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc CurrentSince Mar 3, 2023 Accepting new patients
Albany General Hospital CurrentSince Mar 3, 2023 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Mar 3, 2023 Accepting new patients
Albany General Hospital CurrentSince Mar 3, 2023 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Mar 3, 2023 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Mar 3, 2023 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Mar 3, 2023 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Mar 3, 2023 Accepting new patients
Salem Clinic, PC CurrentSince Nov 15, 2019 Accepting new patients
Salem Imaging LLC PastSince Sep 1, 2019 Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

705 Elm St SW
Ste 300
Albany, OR 97321
Phone (541) 812-4580

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1306494638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 ELM ST SW STE 300",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211958",
            "telephone_number": "541-812-4580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Ryan Dr SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973019687",
            "country_code": "US",
            "telephone_number": "503-399-1262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETZLAFF",
        "first_name": "HAZEL",
        "middle_name": "JADE MILANO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1166933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmilano253907@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "705 Elm St SW Ste 300",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HAZEL",
            "last_name": "MILANO",
            "middle_name": "JADE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.