Russell K Havlicek, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00033493 Issued in WA

Practice address

820 N Chelan Ave
Wenatchee, WA 98801-2028

Phone

(509) 663-8711

NPI assigned

Jul 6, 2006

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

Other identifiers 2

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

Internal Medicine

Education

Creighton University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Central Washington Health Services Home health agency, Wenatchee, WA, CCN 507029
• Central Washington Hospital Homecare Services Hospice, Wenatchee, WA, CCN 501516
• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016
• Lake Chelan Community Hospital Hospital, Chelan, WA, CCN 501334

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rhavlicek1915@edirect.chehr.org

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.

• Central Washington Health Services Association

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  Medicare reassignment Care Compare group NPD
• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD
• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1881642239
  NPD
• Wenatchee Valley Hospital

  • Clinical Medical Laboratory
  • Wenatchee, WA
  • NPI 1689916819
  NPD
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1538151733
  NPD (past)

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

• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation
• Central Washington Health Services Association

  • Community Based Hospice Care Agency
  • Wenatchee, WA
  • NPI 1508978388
  Care Compare affiliation
• Central Washington Health Services Association

  • Home Health Agency
  • Wenatchee, WA
  • NPI 1699888024
  Care Compare affiliation
• Chelan County Public Hospital District No 2

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1578568853
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1861423741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLICEK",
        "first_name": "RUSSELL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00033493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "106466",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861423741",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allegra Hart, N.D.
• Alison Diane Hartvigson, MD
• Amy Haske
• Alan L. Hauber, CDP
• Gary Hauber, RPH
• Melissa Ann Hawes
• Crystle Lyn Hawkins, LMP
• Natalie Katharyn Hawkins
• Nicole Rachel Hawkins
• Alexia Hayes

• Internal Medicine Physician in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.