NPIMap

Individual provider Active NPI

Hazel Wiley, D.O

  • Neurology Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1821208794
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
5101016564 Issued in MI
Practice address
4900 W Oakland Park Blvd
Suite 309
Lauderdale Lakes, FL 33313-7500
Phone
(954) 821-0737
NPI assigned
May 22, 2007
Last updated
Feb 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 5101016564 MI Primary

Addresses

Primary practice location

4900 W Oakland Park Blvd
Suite 309
Lauderdale Lakes, FL 33313-7500

Mailing address

PO Box 9834
Coral Springs, FL 33075-0834
Phone (954) 821-0737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091208000556 FL Practitioner - Neurology 3072652858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

201 E Sample Rd
FL 1
Pompano Beach, FL 33064-3502
Phone (954) 786-7392

8130 Royal Palm Blvd
Suite 101
Coral Springs, FL 33065-5703
Phone (954) 340-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101016564MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District CurrentSince May 1, 2016 Accepting new patients
Hazel Wiley, D.O., P.a. Neurology CurrentSince Mar 1, 2010 Accepting new patients
North Broward Hospital District CurrentSince May 1, 2016 Accepting new patients
North Broward Hospital District Current Accepting new patients
North Broward Hospital District Past Accepting new patients
Vision Quest Ophthalmology, LLC Past Accepting new patients

Locations

8130 Royal Palm Blvd
Ste 101
Coral Springs, FL 33065
Phone (954) 255-9930

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

201 E Sample Rd
Fl 1
Deerfield Beach, FL 33064
Phone (954) 786-7392

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

4900 W Oakland Park Blvd
Ste 309
Lauderdale Lakes, FL 33313
Phone (954) 340-1500

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1821208794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9834",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330750834",
            "telephone_number": "954-821-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W OAKLAND PARK BLVD",
            "address_2": "SUITE 309",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137500",
            "telephone_number": "954-821-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "HAZEL",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5101016564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.