Breanna Haglund, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002628A Issued in FL

Practice address

2512 E Dupont Rd Ste 200
Fort Wayne, IN 46825-1609

Phone

(260) 748-3650

Fax

(260) 748-3651

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Racc Medical Associates LLCGroup PAC ID 0648424127, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Racc Medical Associates LLC

  • Physical Medicine & Rehabilitation Physician
  • Fort Wayne, IN
  • NPI 1184976136

  IN

  Medicare reassignment Care Compare group NPD
• Racc Medical Associates LLC

  • Durable Medical Equipment & Medical Supplies
  • Warsaw, IN
  • NPI 1912666744
  Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335

  Hospital

  Care Compare affiliation
• Parkview Hospital, Inc.

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1720558786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "HUNTERTOWN",
            "state": "IN",
            "postal_code": "467480670",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 E DUPONT RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251609",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6811 Lima Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468181145",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2124 N Biomet Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465827858",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 E 7th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "467062533",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1721 Magnavox Way",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468041537",
            "country_code": "US",
            "telephone_number": "260-748-3650",
            "fax_number": "260-748-3651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGLUND",
        "first_name": "BREANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "10002628A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross Haffner
• Brett Alan Hagedorn, MD
• Sarah Hagee, DDS
• Nicole Alexandra Hagen
• Jennifer Hager, DNP, MBA, CRNA
• Eunice Wanjiku Hahn, PMHNP
• Ruby Hahn
• William Otis Haines
• Mallory Hainlin
• Danelle Hair

• All providers in Fort Wayne, IN
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.
• 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.