Active NPI
Tyler Hauf
- Physician Assistant
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 055-0031586
- Practice address
- Medex Northwest
4311 11TH Ave NE, Suite 200
Seattle, WA 98105 - Phone
- (206) 616-4001
- NPI assigned
- Sep 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 055-0031586 | VT | Primary |
| Physician Assistant | 363A00000X | PA61115512 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
Medex Northwest
4311 11TH Ave NE, Suite 200
Seattle, WA 98105
Mailing address
Medex Northwest
4311 11TH Ave NE, Suite 200
Seattle, WA 98105
Other practice location 1
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Washington School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055-0031586 | VT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Current | Accepting new patients | |
| Fletcher Allen Health Care Inc | Past | Accepting new patients |
Locations
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
62 Tilley Dr
Ste 101
South Burlington, VT 05403
Phone (802) 847-4514
Interoperability endpoints
- thauf508667@direct.uvmhealth.org
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
-
- Radiation Oncology Physician
- Burlington, VT
- NPI 1619266624
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Burlington, VT
- NPI 1568419976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1720638547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDEX NORTHWEST",
"address_2": "4311 11TH AVE NE, SUITE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDEX NORTHWEST",
"address_2": "4311 11TH AVE NE, SUITE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105",
"telephone_number": "206-616-4001"
}
],
"practiceLocations": [
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "802-847-4600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAUF",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-13",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VT",
"license": "055-0031586",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA61115512",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.