Kathleen M Hazel, NP CNM MSN

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

003737 Issued in CT

Practice address

80 Seymour Street
Hartford Hospital OB/GYN Dept
Hartford, CT 06102

Phone

(860) 972-2780

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 7

Other names 1

• Ms. Kathleen M Whalen Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OBGYN Group of Eastern Connecticut PCGroup PAC ID 2769370352, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Nurse Midwife, Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.hazel.1@27673.direct.athenahealth.com

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.

• OBGYN Group of Eastern Connecticut, P.C.

  • Obstetrics & Gynecology Physician
  • South Windsor, CT
  • NPI 1376756908
  Medicare reassignment Care Compare group NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• OB-GYN Associates of Ithaca, LLP

  • Obstetrics & Gynecology Physician
  • Ithaca, NY
  • NPI 1437229945
  NPD (past)

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

• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Care Compare affiliation

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1619043742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL OB/GYN DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL OB/GYN DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06102",
            "telephone_number": "860-972-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEL",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP CNM MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "F-420766-1",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "F420766-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F420766-1",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F-420766-1",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "003737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00362863",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MIDWIFE LICENSE",
            "identifier": "000379",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "140082",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE- MIDWIFE",
            "identifier": "16805",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWIFE LICENSE",
            "identifier": "379",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "F-420766-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02914276",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WHALEN",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "CNM, MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Advanced Practice Midwife in Hartford, CT
• Providers in Hartford, CT by specialty
• Advanced Practice Midwife in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.