Individual provider Active NPI

Rachael E Haugen, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1902452386
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0007129 Issued in MD
Practice address
4940 Eastern Ave
Baltimore, MD 21224-2735
Phone
(410) 550-0453
NPI assigned
Aug 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 C0007129 MD Primary

Addresses

Primary practice location

4940 Eastern Ave
Baltimore, MD 21224-2735

Mailing address

9004 Shadybrook Dr
Frederick, MD 21701-5823
Phone (608) 732-5175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190911000574 MD Practitioner - Physician Assistant 0345579777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0100

Hospital & facility affiliations

  • Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0007129MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Aug 15, 2019 Accepting new patients
Johns Hopkins University CurrentSince Aug 15, 2019 Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

Interoperability endpoints

  • Direct secure messaging: rhaugen552031@direct.hopkinsmedicine.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1902452386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 SHADYBROOK DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015823",
            "telephone_number": "608-732-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "RACHAEL",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.