NPIMap

Individual provider Active NPI

Haseeb Ben Kazim, MD

  • Hospitalist Physician
  • Tavares, FL
National Provider Identifier
1346273786
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME82057 Issued in FL
Practice address
1000 Waterman Way
Tavares, FL 32778-5266
Phone
(352) 742-8836
Fax
(352) 742-8829
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME82057 FL
Hospitalist Physician 208M00000X ME82057 FL Primary

Addresses

Primary practice location

1000 Waterman Way
Tavares, FL 32778-5266

Mailing address

1741 David Walker Dr
Tavares, FL 32778-5745
Phone (352) 742-8836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210304002721 ND Practitioner - Internal Medicine 5092841049 Reassigns benefits to 2 organizations
I20241022005310 TX Practitioner - Hospitalist 5092841049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McKenzie County Healthcare Systems IncGroup PAC ID 5890768006, shared by 5 NPIs, 63 clinicians

Practice addresses (Care Compare)

509 16TH St NE
Suite 3
Watford City, ND 58854-7628
Phone (701) 444-7814

709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000

US Hwy 160 S
MP 394
Kayenta, AZ 86033-0368
Phone (928) 697-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME82057FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie County Healthcare Systems Inc CurrentSince Nov 28, 2020 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Oct 4, 2024 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Oct 4, 2024 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Oct 4, 2024 Accepting new patients
Kayenta Alternative Rural Hospital Current Accepting new patients
McKenzie County Healthcare Systems Inc Internal Medicine CurrentSince Nov 28, 2020 Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients

Locations

1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

525 N Main St
Watford City, ND 58854
Phone (701) 842-3771

1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470

Organizations & group practices 11

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 2

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1346273786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-742-8836",
            "fax_number": "352-742-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266",
            "telephone_number": "352-742-8836",
            "fax_number": "352-742-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIM",
        "first_name": "HASEEB",
        "middle_name": "BEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME82057",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME82057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.