Gary Boyd Haffner, MD
Individual provider Active NPI Hospitalist Physician · Ft. Bidwell, CA
NPI 1407950710 · NPPES record last updated Sep 7, 2012
Key facts
- NPI
- 1407950710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- C39098 (CA)
- Practice address
- 132 Mee Thee-Uh Rd
Ft. Bidwell, CA 96112 - Phone
- (530) 279-6115
- Fax
- (530) 279-6100
- NPI assigned
- Sep 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Loma Linda University School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Fort Bidwell Indian Community
Surprise Valley Health Care District
Practice addresses (Care Compare)
132 Mee Thee-Uh Rd
Fort Bidwell, CA 96112-0247
Phone (530) 279-6194
PO Box
Cedarville, CA 96104
Hospital & facility affiliations
- Surprise Valley Community Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061128000436 | CA | Practitioner - Internal Medicine | 3476551565 | Reassigns benefits to 2 organizations |
| I20181129000705 | TX | Practitioner - Internal Medicine | 3476551565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C39098 | CA | MD | Hospitalist Physician |
| 39098 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surprise Valley Health Care District | Current |
Accepting new patients | |
| Surprise Valley Health Care District | Current |
Accepting new patients | |
| Orohealth Corporation a Non Profit Healthcare System | Current |
Accepting new patients | |
| Surprise Valley Health Care District | Past | Accepting new patients |
Locations
2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544
2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500
Interoperability endpoints
- gary.haffner.p1@direct.warnermountainihp.nextgenshare.com
- https://fhir-usa.unify.chbase.com/org/survalh-86281d9a
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | C39098 | CA | Yes |
Addresses
Primary practice location
132 Mee Thee-Uh Rd
Ft. Bidwell, CA 96112
Mailing address
PO Box 246
745 N. Main Street
Cedarville, CA 96104
Phone (530) 279-6194
Other providers in Ft. Bidwell, CA
All providers in Ft. Bidwell, CA · Hospitalist Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.