Wendy C Haseloff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03164 Issued in TX

Practice address

100 Bourland Rd Ste 100
Keller, TX 76248-3591

Phone

(817) 379-5100

Fax

(817) 379-0479

NPI assigned

Mar 10, 2011

Last updated

Oct 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

University of Texas Medical Branch at Galveston, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085
• Medical City Alliance Hospital, Fort Worth, TX, CCN 670103

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: whaseloff1356265@direct.texashealth.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.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD (past)
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

• North Texas - Mca LLC

  dba Medical City Alliance

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871911016
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Alliance

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1215296884
  Care Compare affiliation

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1699073999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BOURLAND RD STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483591",
            "telephone_number": "817-379-5100",
            "fax_number": "817-379-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOURLAND RD STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483591",
            "telephone_number": "817-379-5100",
            "fax_number": "817-379-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELOFF",
        "first_name": "WENDY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170258105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Harris, PHARM.D
• Thomas Kent Hart, A.T.,C.
• Michelle Bette Harvey, PHD
• Ramona K. Harwell, LPC
• Robert G Harwell, MA LPC
• Amber Hatley, DO
• Dax Hawkins
• Nicole Hawkins, MA, RD
• Timothy Hawley
• Hawleymed PC (Bear Creek Family Medicine)

• Physician Assistant in Keller, TX
• Providers in Keller, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.