Michael Ray Haskell, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

576 Issued in WY

Practice address

120 East Howard Avenue
Teton Valley Health Care
Driggs, ID 83422-5112

Phone

(208) 354-6302

Fax

(208) 354-3158

NPI assigned

Apr 13, 2013

Last updated

Dec 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Teton Valley Health Care IncGroup PAC ID 3870744956, shared by 4 NPIs, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Teton Valley Hospital Hospital, Driggs, ID, CCN 131313

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.haskell.1@15468.direct.athenahealth.com

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.

• Teton Valley Health Care Inc

  dba Driggs Clinic

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183

  Orthopaedic Surgery

  Medicare reassignment NPD
• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Medicare reassignment NPD
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Teton Valley Health Care Inc

  dba Teton Valley Health Care

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Care Compare affiliation

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

{
    "created_epoch": "1365811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1457794083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 EAST HOWARD AVENUE",
            "address_2": "TETON VALLEY HEALTH CARE",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225112",
            "telephone_number": "208-354-6352",
            "fax_number": "208-354-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EAST HOWARD AVENUE",
            "address_2": "TETON VALLEY HEALTH CARE",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225112",
            "telephone_number": "208-354-6302",
            "fax_number": "208-354-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKELL",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-13",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "576",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FPC PLLC (Four Peaks Clinic and Urgent Care)
• Anna Giemza-Palmer, NP
• Rilee Glenn, DPT
• Lisa K Grutzmacher, PAT
• Anna McCamy Gunderson, PA-C
• High Peaks Physical Therapy P a
• Stephanie Lee Hill, BSN
• Chad Rodger Horrocks, MD
• Hunters Inc (Corner Drug)
• Hunters Incorporated

• Medical Physician Assistant in Driggs, ID
• Providers in Driggs, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.