Individual provider Active NPI

Ellen M Hauptmann, MD

  • Diagnostic Radiology Physician
  • Shoreline, WA
National Provider Identifier
1669543708
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00028563 Issued in WA
Practice address
16935 14TH Ave NW
Shoreline, WA 98177-3840
Phone
(952) 595-1100
Fax
(612) 294-4903
NPI assigned
Nov 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 306861 LA
Diagnostic Radiology Physician 2085R0202X MD00028563 WA Primary

Addresses

Primary practice location

16935 14TH Ave NW
Shoreline, WA 98177-3840

Mailing address

11995 Singletree LN
Ste 500
Eden Prairie, MN 55344-5347
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306861LAMDDiagnostic Radiology Physician
MD00028563WAMDDiagnostic Radiology Physician

Interoperability endpoints

  • Direct secure messaging: ehauptmann133685@uihcdirect.org
  • Direct secure messaging: ellen.hauptmann@direct.vmmc.org

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1669543708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16935 14TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773840",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPTMANN",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "306861",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00028563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.