Miles Alan Haeberle, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

611 Clinic Rd
Challis, ID 83226-4824

Phone

(208) 879-4351

Fax

(208) 879-5216

NPI assigned

Sep 20, 2017

Last updated

Jun 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 ID

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Challis Area Health Center IncorporatedGroup PAC ID 2769779776, 8 clinicians

Steele Memorial Medical CenterGroup PAC ID 9436131265, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13547/brand/1/csg/1/fhir/r4
• Direct secure messaging: mhaeberle3864966@wm.providencedirect.org
• Direct secure messaging: miles.haeberle.1@13547.direct.athenahealth.com

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.

• Steele Memorial Medical Center

  • Critical Access Hospital
  • Salmon, ID
  • NPI 1851403265
  Medicare reassignment Care Compare group NPD
• Challis Area Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Challis, ID
  • NPI 1013387877
  Medicare reassignment Care Compare group
• Challis Area Health Center

  • Medical Physician Assistant
  • Challis, ID
  • NPI 1538251996
  NPD (past)
• Just 4 Kids Health LLC

  dba Just 4 Kids Urgent Care

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1043722259
  NPD (past)

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• Steele Memorial Medical Center

  • Critical Access Hospital
  • Salmon, ID
  • NPI 1851403265
  Care Compare affiliation

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1710496997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "832260980",
            "telephone_number": "208-879-4351",
            "fax_number": "208-879-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CLINIC RD",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "832264824",
            "telephone_number": "208-879-4351",
            "fax_number": "208-879-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEBERLE",
        "first_name": "MILES",
        "middle_name": "ALAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Edwards Dmochowski, DC
• Eagles Wings Transportation
• Eagles Wings Transportation
• Thomas Daniel Fife, PA-C
• R Patrick Fox
• Melissa Hardy
• Hill Speech & Language Therapy Inc.
• Kenneth Henry Hyatt, PA-C
• Patricia Hyatt, P.T.
• Idaho State University

• Physician Assistant in Challis, ID
• Providers in Challis, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.