Michael Hatzakis Jr., M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00039697 Issued in WA

Practice address

4140 Factoria Blvd SE Ste a
Bellevue, WA 98006-5261

Phone

(425) 389-4200

Fax

(425) 389-4100

NPI assigned

Mar 2, 2006

Last updated

Dec 20, 2019By 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 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2020 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bellevue Rehab Associates, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Bellevue, WA
  • NPI 1710161351
  NPD (past) Authorized official
• Bellevue Rehab Associates

  dba Rehab Options of Issaquah

  • Physical Therapist
  • Issaquah, WA
  • NPI 1447628920
  NPD (past)
• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1699742114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261",
            "telephone_number": "425-389-4200",
            "fax_number": "425-389-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FACTORIA BLVD SE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065261",
            "telephone_number": "425-389-4200",
            "fax_number": "425-389-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZAKIS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00039697",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WA",
            "license": "MD00039697",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00039697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "0201840",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hatzakis@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "CCD XML Through PracticeFusion",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD XML",
            "address_1": "4140 Factoria Blvd SE Ste A",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980065261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Masar Hamza Hassoun
• Taylor Hatch
• Hattingh Holdings Inc (Northwest Prosthetic & Orthotic Clinic)
• Debra S Hatton, MA, LMHC
• Megan Ross Hatton
• Sarah Hauer, OT
• Pauline Lois Haugen, DC
• Scott J Haugen, M.D.
• Stefanie D Haugen, DC
• Ralph D Havens, M.D.

• Physical Medicine & Rehabilitation Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.