Individual provider Active NPI

Katherine E. R. Hazzard, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1346853801
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61214953 Issued in WA
Practice address
601 Broadway FL 7
Seattle, WA 98122-5330
Phone
(206) 386-2600
Fax
(206) 622-1644
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61214953 WA Primary

Addresses

Primary practice location

601 Broadway FL 7
Seattle, WA 98122-5330

Mailing address

601 Broadway FL 7
Seattle, WA 98122-5330
Phone (206) 386-2600

Other practice location 1

20700 Bond Rd NE Ste 105
Poulsbo, WA 98370-9099
Phone (206) 386-2600

Other practice location 2

4455 148th Ave NE # B1
Bellevue, WA 98007-3120
Phone (206) 386-2600

Other practice location 3

751 NE Blakely Dr Ste 4020
Issaquah, WA 98029-6201
Phone (206) 386-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211108001221 WA Practitioner - Physician Assistant 5496144701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Opa Ortho PLLCGroup PAC ID 7012371305, 42 clinicians

Practice addresses (Care Compare)

601 Broadway
Suite 700
Seattle, WA 98122-5330
Phone (206) 622-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc., P.S. Surgical CurrentSince Nov 5, 2021 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Nov 5, 2021 Accepting new patients

Locations

7320 216th St SW
Ste 320
Edmonds, WA 98026
Phone (425) 673-3900

751 NE Blakely Dr
Ste 4020
Issaquah, WA 98029
Phone (425) 313-7077

20700 Bond Rd NE
Ste 105
Poulsbo, WA 98370
Phone (206) 623-0922

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

601 Broadway
#700
Seattle, WA 98122
Phone (206) 622-2600

601 Broadway
Fl 7
Seattle, WA 98122
Phone (206) 518-6311

601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100

Interoperability endpoints

  • Direct secure messaging: katherinekate.hazzard.p1@direct.opa.nextgenshare.com

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.

Hospital & facility affiliations 1

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1346853801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROADWAY FL 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225330",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY FL 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225330",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20700 Bond Rd NE Ste 105",
            "address_purpose": "LOCATION",
            "city": "Poulsbo",
            "state": "WA",
            "postal_code": "983709099",
            "country_code": "US",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4455 148th Ave NE # B1",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073120",
            "country_code": "US",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "751 NE Blakely Dr Ste 4020",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "206-386-2600",
            "fax_number": "206-622-1644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZZARD",
        "first_name": "KATHERINE",
        "middle_name": "E. R.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61214953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.