NPIMap

Individual provider Active NPI

Joseph Hazan, MD

  • Obstetrics & Gynecology Physician
  • Saint Peters, MO
National Provider Identifier
1881786960
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35321 Issued in MO
Practice address
4200 N Cloverleaf Dr
Ste H
St Peters, MO 63376
Phone
(636) 928-1800
Fax
(636) 928-2226
NPI assigned
Sep 28, 2006
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35321 MO Primary

Addresses

Primary practice location

4200 N Cloverleaf Dr
Ste H
St Peters, MO 63376

Mailing address

4200 N Cloverleaf Dr
Ste H
St Peters, MO 63376
Phone (636) 928-1800

Other identifiers 1

IdentifierTypeStateIssuer
200646727MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110712000752 MO Practitioner - Obstetrics/Gynecology 2567630890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10345 Watson Rd
American Medical Missouri
Saint Louis, MO 63127-1105
Phone (314) 965-6033

16216 Baxter Rd
Chesterfield, MO 63017-4778
Phone (636) 449-4700

3071 S Grand Ave
Carthage, MO 64836-7851
Phone (417) 310-9286

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35321MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McPherson Medical & Diagnostic, LLC Current Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Sep 1, 2023 Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Sep 1, 2023 Accepting new patients
McPherson Medical & Diagnostic, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

16216 Baxter Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 449-4700

10345 Watson Rd
Saint Louis, MO 63127
Phone (314) 384-3584

4200 N Cloverleaf Dr
Ste H
Saint Peters, MO 63376
Phone (636) 928-1800

216 W Main St
Steele, MO 63877
Phone (573) 695-2181

216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181

Organizations & group practices 5

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1881786960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 N CLOVERLEAF DR",
            "address_2": "STE H",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-928-1800",
            "fax_number": "636-928-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 N CLOVERLEAF DR",
            "address_2": "STE H",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-928-1800",
            "fax_number": "636-928-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZAN",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "35321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200646727",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.