Individual provider Active NPI

Tristan Michael Hasbargen, PA

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1861746778
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9106784 Issued in FL
Practice address
1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone
(850) 877-4134
Fax
(850) 402-9130
NPI assigned
Oct 30, 2012
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9106784 FL Primary

Addresses

Primary practice location

1707 Riggins Rd
Tallahassee, FL 32308-5317

Mailing address

PO Box 13859
Tallahassee, FL 32317-3859
Phone (850) 877-4134

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
I20150401000416 FL Practitioner - Physician Assistant 8820315898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone (850) 877-4134

3009 4TH St
Marianna, FL 32446-2122
Phone (850) 877-4134

Merit-based Incentive Payment System (MIPS)

Final score
89.59 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
72.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9106784FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Tallahassee PA CurrentSince Jan 27, 2015 Accepting new patients

Locations

3009 4th St
Marianna, FL 32446
Phone (850) 526-3937

425 W 19th St
Ste De
Panama City, FL 32405
Phone (850) 818-0220

1707 Riggins Rd
Tallahassee, FL 32308
Phone (850) 205-6232

Interoperability endpoints

  • Direct secure messaging: thasbargen@dat1977.srs-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1861746778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13859",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173859",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 RIGGINS RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085317",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASBARGEN",
        "first_name": "TRISTAN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9106784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.