Individual provider Active NPI

Edwin Hauser, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1760487185
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2296 Issued in FL
Practice address
1325 San Marco Blvd
Suite 200
Jacksonville, FL 32207-8559
Phone
(904) 346-3465
Fax
(904) 858-6475
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2296 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd
Suite 200
Jacksonville, FL 32207-8559

Mailing address

1325 San Marco Blvd
Ste 701
Jacksonville, FL 32207-8568
Phone (904) 346-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20111220000584 FL Practitioner - Physician Assistant 1153597281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Orthopaedic Institute IncGroup PAC ID 5193625499, 60 clinicians

Practice addresses (Care Compare)

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8549
Phone (904) 858-7045

1325 San Marco Blvd
Suite 200
Jacksonville, FL 32207-8566
Phone (904) 346-3465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Improvement activities
40
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2296FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ehauser@joi.medalliesdirect.net

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1760487185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "STE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078559",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSER",
        "first_name": "EDWIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.