Individual provider Active NPI

Christine Matthew Hazlett, CRNP

  • Family Nurse Practitioner
  • Collegeville, PA
National Provider Identifier
1629369277
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SPO11343 Issued in PA
Practice address
305 W Second Avenue
Collegeville, PA 19426
Phone
(610) 489-2721
NPI assigned
Apr 29, 2011
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SPO11343 PA Primary

Addresses

Primary practice location

305 W Second Avenue
Collegeville, PA 19426

Mailing address

305 W Second Avenue
Collegeville, PA 19426
Phone (610) 489-2721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20111212000350 PA Practitioner - Nurse Practitioner 7416122973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

120 Valley Green Lane
Suite 510
King of Prussia, PA 19406
Phone (484) 324-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SPO11343PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Medical Group LLC CurrentSince Oct 1, 2015 Accepting new patients
Main Line Healthcare CurrentSince Mar 1, 2023 Accepting new patients
Green and Seidner Family Practice Associates PC Past Accepting new patients
Lansdale Hospital Corporation Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

120 Valley Green Ln
Ste 510
King of Prussia, PA 19406
Phone (484) 324-7100

283 Lancaster Ave
Malvern, PA 19355
Phone (610) 296-4170

10000 Shannondell Dr
Norristown, PA 19403
Phone (610) 728-5236

146 Marple Rd
Radnor, PA 19008
Phone (215) 735-0595

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1629369277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W SECOND AVENUE",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "19426",
            "telephone_number": "610-489-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W SECOND AVENUE",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "19426",
            "telephone_number": "610-489-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLETT",
        "first_name": "CHRISTINE",
        "middle_name": "MATTHEW",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SPO11343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

Verify at the official NPI Registry.