Individual provider Active NPI

Amy Patricia Hauck, MD

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1316911910
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
H4391 Issued in TX
Practice address
2080 Child St
Naval Hospital Jacksonville
Jacksonville, FL 32214-5005
Phone
(904) 542-7435
Fax
(904) 542-7442
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H4391 TX
Hospitalist Physician 208M00000X H4391 TX Primary

Addresses

Primary practice location

2080 Child St
Naval Hospital Jacksonville
Jacksonville, FL 32214-5005

Mailing address

11712 Running Fox TRL
Austin, TX 78759-4245
Phone (512) 657-3329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080318000296 TX Practitioner - Pediatric Medicine 0446336341 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H4391TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Texas Billing, Inc. Pediatrics CurrentSince May 25, 2011 Accepting new patients
Ascension Seton Past Accepting new patients
Babies 411 LLC Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Locations

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855

Interoperability endpoints

  • Direct secure messaging: ahauck@yourcarecommunity.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1316911910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 RUNNING FOX TRL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594245",
            "telephone_number": "512-657-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "address_2": "NAVAL HOSPITAL JACKSONVILLE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-542-7435",
            "fax_number": "904-542-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "AMY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H4391",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "H4391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.