Raselette Agatha Hunt

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME111370 Issued in FL

Practice address

2292 Forest LN
Harrisburg, PA 17112-6004

Phone

(717) 513-1499

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Raselette Agatha Wilson Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, GA2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Bartz-Altadonna Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1811279763
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Bartz-Altadonna Community Health Center

  • Community/Retail Pharmacy
  • Lancaster, CA
  • NPI 1700672011
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1649445800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2292 FOREST LN",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171126004",
            "telephone_number": "717-513-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2292 FOREST LN",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171126004",
            "telephone_number": "717-513-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "RASELETTE",
        "middle_name": "AGATHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD444348",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9201 Big Horn Blvd",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957581240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RASELETTE",
            "last_name": "WILSON",
            "middle_name": "AGATHA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marissa Irene Hummel, MS SLP-CCC
• Wesley Hummel, OT
• John Michael Hundertmark, LSW
• Lauren Elizabeth Hunsberger, CRNP
• Eileen M Hunt, LPC
• Huntleigh Healthcare LLC
• Vanessa Hupp, PHARMD
• Karl G. Hursey, PHD
• Huston Family Chiropractic and Wellness Center
• Katherine Hutcheson

• Family Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.