NPIMap

Individual provider Active NPI

Kaeley Rose Hahn, PA-C

  • Medical Physician Assistant
  • Midland, MI
National Provider Identifier
1992567465
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601012250 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-2000
Phone
(989) 839-3000
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601012250 MI Primary

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-2000

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240214003602 MI Practitioner - Physician Assistant 3072957398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians
Mymichigan Medical Center West BranchGroup PAC ID 7214251081, 75 clinicians

Practice addresses (Care Compare)

2463 S M
Suite 30
West Branch, MI 48661-9312
Phone (989) 345-3660

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

609 Quarter St
Suite 7
Gladwin, MI 48624-1941
Phone (989) 343-1134

Hospital & facility affiliations

  • Mymichigan Medical Center West Branch Hospital, West Branch, MI, CCN 230095
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
  • Mymichigan Medical Center Alma Hospital, Alma, MI, CCN 230030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Apr 1, 2024 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 1, 2024 Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Mar 1, 2026 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients

Locations

609 Quarter St
Ste 7
Gladwin, MI 48624
Phone (989) 343-1134

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2431 S M 30
West Branch, MI 48661
Phone (989) 343-2487

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

Interoperability endpoints

  • Direct secure messaging: khahn138713@mymichiganhealth.midirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1992567465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "KAELEY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601012250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.