Marc Havlicek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

20230212235 Issued in MO

Practice address

3801 S National Ave
Springfield, MO 65807-5210

Phone

(417) 269-6583

Fax

(417) 269-6573

NPI assigned

Apr 12, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Merit-based Incentive Payment System (MIPS)

Final score

81.52 of 100Reported as group

Quality

61.64

Promoting interoperability

100

Improvement activities

40

Cost

76.77

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Lester E. Cox Medical Centers

  • Family Medicine Physician
  • Shell Knob, MO
  • NPI 1538334396
  Medicare reassignment
• Skaggs Community Hospital Association

  • Cardiovascular Disease Physician
  • Branson, MO
  • NPI 1346602646
  Medicare reassignment
• Lester E Cox Medical Centers

  • Neurology Physician
  • Springfield, MO
  • NPI 1023763414
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1922126077
  NPD
• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Willow Springs, MO
  • NPI 1417122326
  NPD (past)

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1558057679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-6583",
            "fax_number": "417-269-6573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Branson Landing Blvd",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "417-875-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVLICEK",
        "first_name": "MARC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "20230212235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline A. Hauer, M.D.
• Krista Ann Haugland, OTR
• Mitchell Dean Hauschildt, MA, ATC, CSCS
• Sanjay Havaldar, MD
• Richard L Havens, CRNA
• Jacob Havlin
• Tiffany Sue Havlin, PH.D., LCSW
• Arthur S Hawes, MD
• Amber Adaire Hawkins, M.D.
• Amber Marie Hawkins, M.ED., BCBA, LBA

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.