NPIMap

Individual provider Active NPI

Michaela Mary Hasenkrug, DO

  • Emergency Medicine Physician
  • Kingman, AZ
National Provider Identifier
1851955900
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18399 Issued in ND
Practice address
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone
(928) 757-2101
NPI assigned
Apr 24, 2019
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 18399 ND Primary

Addresses

Primary practice location

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

1990 Red Crow Rd
Victor, MT 59875-9633
Phone (406) 360-9083

Other practice location 1

450 E Main St
Rexburg, ID 83440-2048
Phone (208) 359-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220623001532 ND Practitioner - Emergency Medicine 2860871746 Reassigns benefits to 5 organizations
I20250715003279 ID Practitioner - Emergency Medicine 2860871746 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steele Memorial Medical CenterGroup PAC ID 9436131265, 25 clinicians
Madison Memorial HospitalGroup PAC ID 4183949522, 20 clinicians

Practice addresses (Care Compare)

203 S Daisy St
Salmon, ID 83467-4709
Phone (208) 756-5600

450 E Main St
Reburg, ID 83440-2048
Phone (208) 359-6516

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.5 of 100Reported as group
Quality
79.54
Improvement activities
40
Cost
78.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18399NDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Devils Lake CurrentSince Apr 21, 2024 Accepting new patients
Healthsource Partners ND LLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Madison Memorial Hospital CurrentSince Aug 30, 2025 Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Mercy Medical Center Emergency Medicine CurrentSince Nov 22, 2024 Accepting new patients
Mercy Hospital of Devils Lake Emergency Medicine CurrentSince Apr 21, 2024 Accepting new patients
Mercy Medical Center Current Accepting new patients
Steele Memorial Medical Center CurrentSince Jul 15, 2025 Accepting new patients
Mercy Home Care CurrentSince Nov 22, 2024 Accepting new patients
Mercy Medical Center Current Accepting new patients
Steele Memorial Medical Center CurrentSince Jul 15, 2025 Accepting new patients

Locations

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

3290 Solutions Ctr
Chicago, IL 60677

3369 Solutions Ctr
Chicago, IL 60677

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

1213 15th Ave W
Williston, ND 58801
Phone (701) 572-7641

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d61ab3e4-55bb-4859-99e6-22c413b48f2a/

Organizations & group practices 11

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 4

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1851955900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 RED CROW RD",
            "city": "VICTOR",
            "state": "MT",
            "postal_code": "598759633",
            "telephone_number": "406-360-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Main St",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402048",
            "country_code": "US",
            "telephone_number": "208-359-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASENKRUG",
        "first_name": "MICHAELA",
        "middle_name": "MARY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "18399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.