NPIMap

Individual provider Active NPI

John G Haeberle, M.D.

  • Family Medicine Physician
  • Newcastle, WY
National Provider Identifier
1619901907
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8128A Issued in WY
Practice address
1121 Washington Blvd
Newcastle, WY 82701-2968
Phone
(307) 746-6720
Fax
(307) 746-9744
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8128A WY Primary

Addresses

Primary practice location

1121 Washington Blvd
Newcastle, WY 82701-2968

Mailing address

1121 Washington Blvd
Newcastle, WY 82701-2968
Phone (307) 746-6720

Other identifiers 1

IdentifierTypeStateIssuer
127701400MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090626000569 WY Practitioner - Family Practice 6305997925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Weston County Hospital DistrictGroup PAC ID 0042293276, 12 clinicians
Cedar Hills Family Clinic, P.C.Group PAC ID 7315929056, 7 clinicians

Practice addresses (Care Compare)

1121 Washington Blvd
Newcastle, WY 82701-2968
Phone (307) 746-6720

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weston County Hospital District CurrentSince Sep 2, 2024 Accepting new patients
Weston County Hospital District CurrentSince Sep 1, 2025 Accepting new patients
Weston County Hospital District Past Accepting new patients

Locations

1121 Washington Blvd
Newcastle, WY 82701
Phone (307) 746-3582

1124 Washington Blvd
Newcastle, WY 82701
Phone (307) 746-3715

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Weston County Hospital DistrictNewcastle, WY, CCN 535023 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1619901907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 WASHINGTON BLVD",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012968",
            "telephone_number": "307-746-6720",
            "fax_number": "307-746-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 WASHINGTON BLVD",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012968",
            "telephone_number": "307-746-6720",
            "fax_number": "307-746-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEBERLE",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "8128A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127701400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newcastle, WY

Sources for this page

Verify at the official NPI Registry.