Individual provider Active NPI

Roland Haj, D.O.

  • Surgery Physician
  • Sierra Vista, AZ
National Provider Identifier
1578943585
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
008518 Issued in AZ
Practice address
75 Colonia de Salud Ste 100C
Sierra Vista, AZ 85635-2485
Phone
(520) 452-0144
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 008518 AZ Primary

Addresses

Primary practice location

75 Colonia de Salud Ste 100C
Sierra Vista, AZ 85635-2485

Mailing address

45 Parsons Blvd
Flushing, NY 11357

Other practice location 1

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200713001043 AZ Practitioner - General Surgery 6204171325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Vista Regional Health Center Medical Group LLCGroup PAC ID 3779732854, 45 clinicians

Practice addresses (Care Compare)

5700 E Hwy 90
FL 4
Sierra Vista, AZ 85635-9110
Phone (520) 417-3835

7 N San Diego St
Tombstone, AZ 85638-0406
Phone (520) 457-2374

75 Colonia de Salud
Sierra Vista, AZ 85635-2485

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy43
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux40
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
008518AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Vista Regional Health Center Medical Group LLC Surgery CurrentSince Aug 1, 2020 Accepting new patients

Locations

1111 N F Ave
Douglas, AZ 85607
Phone (520) 364-6860

5750 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Ste 200
Sierra Vista, AZ 85635
Phone (520) 263-3500

75 Colonia de Salud
Ste 100C
Sierra Vista, AZ 85635
Phone (520) 452-0144

Interoperability endpoints

  • Direct secure messaging: roland.haj.1@19231.direct.athenahealth.com

Organizations & group practices 1

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1578943585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD STE 100C",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352485",
            "telephone_number": "520-452-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Parsons Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "11355",
            "country_code": "US",
            "telephone_number": "718-670-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAJ",
        "first_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "008518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.