Individual provider Active NPI

Michael Jeremy Hauser, PHARM.D.

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1780936823
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2061 Willesdon Dr W
Jacksonville, FL 32246-8478
Phone
(305) 979-4039
NPI assigned
Oct 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS49187 FL
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2061 Willesdon Dr W
Jacksonville, FL 32246-8478

Mailing address

2061 Willesdon Dr W
Jacksonville, FL 32246-8478
Phone (305) 979-4039

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
I20241227002284 FL Practitioner - Physician Assistant 6901333210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS49187FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Dec 13, 2024 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1350172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1780936823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 WILLESDON DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468478",
            "telephone_number": "305-979-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 WILLESDON DR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468478",
            "telephone_number": "305-979-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSER",
        "first_name": "MICHAEL",
        "middle_name": "JEREMY",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-14",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS49187",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.