Individual provider Active NPI

Susan Michelle Hau UC Dickinson, ABOC

  • Clinic/Center
  • Hamilton, MT
National Provider Identifier
1730852138
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Practice address
239 N 2ND St
Hamilton, MT 59840-2503
Phone
(406) 961-9611
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

239 N 2ND St
Hamilton, MT 59840-2503

Mailing address

PO Box 1318
Hamilton, MT 59840-1318
Phone (406) 802-4768

Other identifiers 1

IdentifierTypeStateIssuer
234658OtherMTAMERICAN BOARD OF OPTICIANRY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marvel Vision Clinic, LLC CurrentSince Sep 12, 2021 Accepting new patients

Locations

239 N 2nd St
Hamilton, MT 59840
Phone (406) 961-9611

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1730852138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1318",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598401318",
            "telephone_number": "406-802-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 N 2ND ST",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402503",
            "telephone_number": "406-961-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAU UC DICKINSON",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "credential": "ABOC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF OPTICIANRY",
            "identifier": "234658",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.