Phillip Andrew Hasenbalg, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OP61645530 Issued in WA

Practice address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Phone

(928) 757-2101

NPI assigned

Apr 28, 2021

Last updated

Feb 19, 2025By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

Pacific NW Un of HS, Col of Osteopathic Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Emergency Physicians LLC

  dba Nep

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  Medicare reassignment Care Compare group NPD

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

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation
• Providence Health & Services Washington

  dba Providence Centralia Hospital

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1598347577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 PACIFIC AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014024",
            "telephone_number": "360-420-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "985201006",
            "country_code": "US",
            "telephone_number": "360-532-8330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 S Scheuber Rd",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985319027",
            "country_code": "US",
            "telephone_number": "360-736-2803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASENBALG",
        "first_name": "PHILLIP",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61645530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest Lavere Harman Jr., MD
• Candace Lynn Harris, CPHT
• Joyce Carolyn Harris
• John Blankenship Hartland, RN
• Mark J Harvancik, EDD
• Michaela Mary Hasenkrug, DO
• Treeva Hausen
• Havasu Dental Group 1 PLLC
• John Brit Haws, PT, DPT
• Patricia D Haydon, D.C.

• Emergency Medicine Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.