Individual provider Active NPI

Laura Grace Haver, PA-C

  • Surgical Physician Assistant
  • Melbourne, FL
National Provider Identifier
1538418678
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9106534 Issued in FL
Practice address
8725 N Wickham Rd Ste 200
Melbourne, FL 32940-2240
Phone
(321) 434-9230
Fax
(321) 434-9269
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9106534 FL Primary

Addresses

Primary practice location

8725 N Wickham Rd Ste 200
Melbourne, FL 32940-2240

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-9230

Other identifiers 2

IdentifierTypeStateIssuer
GV589YOtherFLMEDICARE
010403100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130109000102 FL Practitioner - Physician Assistant 5799938403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8121

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

8725 N Wickham Rd
Melbourne, FL 32940-2240

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-5162

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106534FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Jul 25, 2016 Accepting new patients
Health First Medical Group, LLC CurrentSince Jul 25, 2016 Accepting new patients

Locations

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

8725 N Wickham Rd
Ste 301
Melbourne, FL 32940
Phone (321) 434-9200

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

8725 N Wickham Rd
Ste 200
Viera, FL 32940
Phone (321) 253-4673

Interoperability endpoints

  • Direct secure messaging: lhaver26019@epicdirect.hf.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1538418678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-9230",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 N WICKHAM RD STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402240",
            "telephone_number": "321-434-9230",
            "fax_number": "321-434-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVER",
        "first_name": "LAURA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GV589Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010403100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.