Diane J Haberman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

464 Issued in WI

Practice address

950 S Koeller St
Oshkosh, WI 54902-6175

Phone

(920) 232-0718

NPI assigned

Jan 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dhaberman126609@direct.myadvocateaurora.org

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1366864431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026175",
            "telephone_number": "920-232-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026175",
            "telephone_number": "920-232-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERMAN",
        "first_name": "DIANE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041581",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhaberman126609@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "950 S Koeller St",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549026175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "950 S Koeller St",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549026175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pedro Guevara, MD
• Catherine F Guggino, CNM
• Guided Discovery LLC
• Samantha H Gutche, DPT
• Kathy D Guzman-Gombos, RN
• Steven J Hable, LPC
• Patricia Hablewitz
• Sharon R Haertl, RN
• Ahmad Y Haffar, MD
• Daniel Hafner, PA

• Physician Assistant in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.