NPIMap

Individual provider Active NPI

Mark K Hafen, D.O.

  • Family Medicine Physician
  • American Fork, UT
National Provider Identifier
1306952056
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5960243-1204 Issued in UT
Practice address
226 N 1100 E Ste a
American Fork, UT 84003-2054
Phone
(801) 855-3848
Fax
(801) 855-3854
NPI assigned
Aug 22, 2006
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5960243-1204 UT Primary

Addresses

Primary practice location

226 N 1100 E Ste a
American Fork, UT 84003-2054

Mailing address

226 N 1100 E Ste a
American Fork, UT 84003-2054
Phone (801) 855-3844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20051219000339 UT Practitioner - Family Practice 3971524943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

226 N 1100
American Fork, UT 84003-2054
Phone (801) 855-3841

275 W 200
Lindon, UT 84042-5009
Phone (801) 796-1333

680 E Main St
Lehi, UT 84043-2241
Phone (801) 768-1699

830 N 2000
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions103
Removal of nail tissue1-10
Removal or shaving of skin growth17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Medical - Vineyard Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Premier Family Medical - City Center Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Premier Family Medical Family Medicine Current Accepting new patients
Premier Family Medical - Saratoga Springs Family Medicine Past Accepting new patients

Locations

226 N 1100 E
American Fork, UT 84003
Phone (801) 756-6037

226 N 1100 E
Ste A
American Fork, UT 84003
Phone (801) 763-3841

3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 789-5566

4317 N Pony Express Pkwy
Ste 150
Eagle Mountain, UT 84005
Phone (801) 788-4779

680 E Main St
Lehi, UT 84043
Phone (801) 766-0606

275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333

830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511

1528 N Commerce Dr
Ste 204
Saratoga Springs, UT 84045

707 E Mill Rd
Ste 303
Vineyard, UT 84059
Phone (801) 224-1300

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1306952056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 N 1100 E STE A",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032054",
            "telephone_number": "801-855-3844",
            "fax_number": "801-855-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 N 1100 E STE A",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032054",
            "telephone_number": "801-855-3848",
            "fax_number": "801-855-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "MARK",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5960243-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.