Individual provider Active NPI

Michael Hawa, NP-C

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1376914291
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28185417A Issued in IN
Practice address
225 Crosslake Dr
Evansville, IN 47715-8198
Phone
(812) 477-1558
NPI assigned
Oct 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28185417A IN Primary

Addresses

Primary practice location

225 Crosslake Dr
Evansville, IN 47715-8198

Mailing address

225 Crosslake Dr
Evansville, IN 47715-8198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20151109000393 IN Practitioner - Nurse Practitioner 4587974225 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28185417AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Orthopaedic Surgeons, Inc. Nurse Practitioner CurrentSince Oct 28, 2015 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. CurrentSince Oct 28, 2015 Accepting new patients

Locations

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800

Interoperability endpoints

  • Direct secure messaging: mhawa20344@carelonhealth.direct-ci.com
  • Direct secure messaging: hawm@tsos.srs-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1376914291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWA",
        "first_name": "MICHAEL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28185417A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.