Individual provider Active NPI

Logan Milad Haak, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • San Diego, CA
National Provider Identifier
1952565491
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
110896 Issued in CA
Practice address
1855 1St Ave
Ste 200B
San Diego, CA 92101-2685
Phone
(858) 863-7597
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 49767 AZ
Retina Specialist (Ophthalmology) Physician 207WX0107X 110896 CA Primary
Ophthalmology Physician 207W00000X 49767 AZ

Addresses

Primary practice location

1855 1St Ave
Ste 200B
San Diego, CA 92101-2685

Mailing address

6259 Caminito Luisito
San Diego, CA 92111-7214
Phone (858) 863-7597

Other identifiers 1

IdentifierTypeStateIssuer
977504MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20170803000815 CA Practitioner - Ophthalmology 2769648690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Wisconsin School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

1855 1St Ave
Suite 200B
San Diego, CA 92101-2685
Phone (858) 863-7597

435 H St
Chula Vista, CA 91910-4307
Phone (619) 691-7000

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49767AZMDRetina Specialist (Ophthalmology) Physician
110896CAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Azul Vision Inc. Optometrist CurrentSince Nov 20, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Jan 3, 2018 Accepting new patients
California Eye Specialists Medical Group, Inc Current Accepting new patients
Scripps Health Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Illinois Retina Associates PLLC Ophthalmology PastSince Jan 24, 1991 Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Eyenet Triage, PLC Ophthalmology Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

14726 Ramona Ave
Ste 203
Chino, CA 91710
Phone (626) 305-9100

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

700 Garden View Ct
Ste 100
Encinitas, CA 92024
Phone (760) 452-4270

18250 Roscoe Blvd
Ste 120
Northridge, CA 91325
Phone (818) 583-9924

3621 Vista Way
Oceanside, CA 92056
Phone (760) 607-3460

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lhaak80435@scrippshlth.medalliesdirect.net
  • Direct secure messaging: loganmilad.haak.p1@direct.atlantiseyecare.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lhaak@californiaeye.intellechartdirect.net

Organizations & group practices 12

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 3

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1952565491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 CAMINITO LUISITO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921117214",
            "telephone_number": "858-863-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 1ST AVE",
            "address_2": "STE 200B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012685",
            "telephone_number": "858-863-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAK",
        "first_name": "LOGAN",
        "middle_name": "MILAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AZ",
            "license": "49767",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "110896",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "49767",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "977504",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.