Individual provider Active NPI

Michele A Hazzouri, M.D.

  • Internal Medicine Physician
  • Scranton, PA
National Provider Identifier
1689656936
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD038660L Issued in PA
Practice address
937 Hickory St
Scranton, PA 18505-2199
Phone
(570) 346-5331
Fax
(570) 207-5444
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD038660L PA Primary

Addresses

Primary practice location

937 Hickory St
Scranton, PA 18505-2199

Mailing address

937 Hickory Street
Scranton, PA 18505-2199
Phone (570) 346-5331

Other identifiers 1

IdentifierTypeStateIssuer
0007985320001MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101011000434 PA Practitioner - Internal Medicine 8820280795 Practice locations: Scranton, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

937 Hickory St
Scranton, PA 18505-2181
Phone (570) 346-5331

937 Hickory St
Scranton, PA 18505-2199

Hospital & facility affiliations

  • Traditional Home Health Care Home health agency, Dunmore, PA, CCN 397774
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237
  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD038660LPAMDInternal Medicine Physician

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1689656936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 HICKORY STREET",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052199",
            "telephone_number": "570-346-5331",
            "fax_number": "570-207-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 HICKORY ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052199",
            "telephone_number": "570-346-5331",
            "fax_number": "570-207-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZZOURI",
        "first_name": "MICHELE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD038660L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007985320001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.