Active NPI
William P Hazell, PA
- Medical Physician Assistant
- Boulder, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0001600
- Practice address
- 580 Mohawk Dr
Boulder, CO 80303-3712 - Phone
- (303) 338-4545
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA0001600 | CO | Primary |
Addresses
Primary practice location
580 Mohawk Dr
Boulder, CO 80303-3712
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23358220 | Medicaid | CO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0001600 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Service Physicians, Inc. | Emergency Medicine | Current | Accepting new patients |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Emergency Medicine | Past | Accepting new patients |
| Boulder Emergency Physicians PC | Emergency Medicine | Past | Accepting new patients |
Locations
4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885
8900 E 46th Pl
Denver, CO 80238
Phone (303) 403-6300
200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110
8550 W 38th Ave
Ste 320
Wheat Ridge, CO 80033
Phone (801) 442-4122
8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015
Organizations & group practices 7
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.
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Emergency Medicine
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- NPI 1639454242
-
- Emergency Medicine Physician
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- NPI 1326097668
-
- Emergency Medicine Physician
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- NPI 1548895048
-
- Sports Medicine (Orthopaedic Surgery) Physician
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- NPI 1083598874
-
- Obstetrics & Gynecology Physician
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- NPI 1144834011
-
- Emergency Medicine Physician
- Lafayette, CO
- NPI 1407454317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1467463729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 MOHAWK DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033712",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZELL",
"first_name": "WILLIAM",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA0001600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23358220",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "CAREQUALITY",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "580 Mohawk Dr",
"city": "Boulder",
"state": "CO",
"country_code": "US",
"postal_code": "803033712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.