Jacob Henry Hazellief, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9108172 Issued in FL

Practice address

1040 37TH PL Ste 101
Vero Beach, FL 32960-4808

Phone

(772) 563-4580

Fax

(772) 563-4690

NPI assigned

Sep 19, 2014

Last updated

Sep 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, DC2 enrollments

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 2

Specialty

Physician Assistant

Education

Nova Southeastern College of Osteo Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score

83.36 of 100Reported as group

Quality

73.03

Promoting interoperability

100

Improvement activities

40

Cost

71.49

Merit-based Incentive Payment System (MIPS)

Final score

92.26 of 100Reported as apm

Quality

80.2

Promoting interoperability

99.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jhazellief997588@soc.inova.org

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment Care Compare group NPD
• Indian River Health Services Inc

  dba Irhs-Primary Care South

  • Internal Medicine Physician
  • Vero Beach, FL
  • NPI 1093095333
  NPD
• Inova Health Care Services

  dba Inova Blood Donor Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD

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

• Inova Health Care Services

  dba Inova Fairfax Hospital

  • Rehabilitation Hospital Unit
  • Falls Church, VA
  • NPI 1588795462
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Fairfax Hospital

  • General Acute Care Hospital
  • Falls Church, VA
  • NPI 1831220714
  Care Compare affiliation

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1669874822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7802 SANTA CLARA BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349512514",
            "telephone_number": "772-332-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 37TH PL STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604808",
            "telephone_number": "772-563-4580",
            "fax_number": "772-563-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELLIEF",
        "first_name": "JACOB",
        "middle_name": "HENRY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9108172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Touch Massage Therapy
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• Kevin M Healy, D.C.
• Heart Center of the Treasure Coast

• Physician Assistant in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.