Individual provider Active NPI

Catherine Marie Evangelista Haugen, ANP-BC

  • Adult Health Nurse Practitioner
  • Novi, MI
National Provider Identifier
1649524588
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704163632 Issued in MI
Practice address
39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone
(248) 661-7393
Fax
(248) 344-4103
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704163632 MI
Adult Health Nurse Practitioner 363LA2200X 4704163632 MI Primary

Addresses

Primary practice location

39450 W 12 Mile Rd
Novi, MI 48377-3600

Mailing address

39450 W12 Mile Road
Novi, MI 48377
Phone (842) 661-7393

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chaugen16533@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130104000489 MI Practitioner - Nurse Practitioner 1658524327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Nov 12, 2012 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince Nov 12, 2012 Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

Organizations & group practices 2

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 1

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1649524588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39450 W12 MILE ROAD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "842-661-7393",
            "fax_number": "842-344-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773600",
            "telephone_number": "248-661-7393",
            "fax_number": "248-344-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA HAUGEN",
        "first_name": "CATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704163632",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704163632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaugen16533@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "39450 W 12 Mile Rd",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483773600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.