Collin Brooksby Hafen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP61336718 Issued in WA

Practice address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Phone

(360) 428-2501

Fax

(360) 428-2596

NPI assigned

Apr 16, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alpha Home Health Home health agency, Everett, WA, CCN 507107
• Eden Home Health Home health agency, Bellingham, WA, CCN 507105
• Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hcollin26457@skagit.direct-ci.com

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.

• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Clinics

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Health - Granite Falls Family Medicine

  • Primary Care Clinic/Center
  • Granite Falls, WA
  • NPI 1033164470

  Family Medicine

  NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Health - Mount Vernon Physical Therapy

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Public Hospital Dist No 1 Skagit

  • Specialist
  • Mount Vernon, WA
  • NPI 1629012463
  NPD (past)

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

• Empres Home Health of Bellingham, LLC

  dba Eden Home Health

  • Home Health Agency
  • Bellingham, WA
  • NPI 1316031230
  Care Compare affiliation
• Glacier Peak Healthcare, Inc.

  dba Alpha Home Health

  • Home Health Agency
  • Everett, WA
  • NPI 1518482215
  Care Compare affiliation
• Public Hospital Dist No 1 Skagit

  dba Skagit Valley Hospital

  • General Acute Care Hospital
  • Mount Vernon, WA
  • NPI 1053357244
  Care Compare affiliation

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1770146623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2501",
            "fax_number": "360-428-2596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-814-2349",
            "fax_number": "360-428-2215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "COLLIN",
        "middle_name": "BROOKSBY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61336718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hcollin26457@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabrielle Gunterman
• Emir Barbaros Safak Guven, MD
• Barbara Jean-Weber Guy
• Thomas Lee Haan
• Davis Hackman
• Amber Janae Hagel, MA, CF-SLP
• Haggen, Inc (Haggen Food & Pharmacy, TOP Food & Drug)
• Barbara J. Hahn, MD
• Bryan Boyd Hair, MD
• Affan Haleem, MD

• Family Medicine Physician in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Family Medicine Physician in Washington

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

Verify at the official NPI Registry.