JUSTIN LYELL HAZEN (NPI# 1568482701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568482701 |
| Entity Type | Individual |
| Full Name | JUSTIN LYELL HAZEN |
| Credential | M.D. |
| Practice Address |
4411 Montano Rd Nw Suite F Albuquerque NM 87120-3235 |
| Practice Telephone | 5058994414 |
| Practice Fax Number | 5058982395 |
| Mailing Telephone | 5058994414 |
| Mailing Fax Number | 5058982395 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2004-0125 | NM | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114363603 | Justin C Hazen | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2013-05-11 |
| Street Address |
4411 MONTANO RD NW SUITE F |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87120-3235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699194670 | Gallegos Family Dentistry | Dentist | 4411 Montano Rd Nw, Suite D, Albuquerque, NM 87120-3235 | 2014-04-07 |
| 1194140277 | Duke City Healthcare | Clinic/Center | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2014-02-25 |
| 1003193616 | Roylee Luna | Physical Therapist | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2011-11-10 |
| 1205017795 | Lisa A Edmonds | Occupational Therapist | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2007-11-26 |
| 1013115435 | Mariposa Hand and Rehab Specialists Limited Partnership | Durable Medical Equipment & Medical Supplies | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2007-07-06 |
| 1255480737 | Mariposa Hand & Rehab Specialists | Clinic/Center | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2007-01-10 |
| 1932272911 | Nanette Rae Meyers | Physical Therapist | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2006-11-16 |
| 1467535658 | Kristi M. Fury | Nurse Practitioner | 4411 Montano Rd Nw, Suite F, Albuquerque, NM 87120-3235 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971919 | Erica Denise Ortiz | Social Worker | 6212 Casa Blanca Dr Nw, Albuquerque, NM 87120 | 2020-10-27 |
| 1770133589 | Laura Lee Smith | Technician | 5112 Vista De Luz Nw, Albuquerque, NM 87120 | 2019-09-13 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1831753508 | Jennifer Lydia Castro | Nurse Practitioner | 8428 Hawk Eye Rd Nw, Albuquerque, NM 87120 | 2019-04-27 |
| 1518425065 | Jean Louise Ramsey | Counselor | Office Alternatives/ The Center for Life Changes, 6300 Riverside Plaza Nw, Suite 100, Albuquerque, NM 87120 | 2019-03-04 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1417443276 | Kyle Thomas Lantz | Dentist | 2800-a Coors Blvd Nw, Albuquerque, NM 87120 | 2018-07-05 |
| 1437669736 | Beatrice Ottomanelli | Day Training/Habilitation Specialist | 9180 Coors Blvd. Nw, Apt. 3307, Albuquerque, NM 87120 | 2017-10-02 |
| 1740705516 | Alianza Home Care, LLC | Home Health | 8307 Casa Negra Ct Nw, Albuquerque, NM 87120 | 2017-08-13 |
| 1366963399 | Jamie Farris | Registered Nurse | 8201 Golf Course Road Northwest, Suite D3 #121, Albuquerque, NM 87120 | 2017-06-29 |
| Find all providers in zip 87120 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730612359 | Adam Michael Tolar | Emergency Medicine | Mcs 11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2017-04-10 |
| 1538691712 | David Scott Fischman | Emergency Medicine | 6400 Paseo Del Norte Blvd Ne, Albuquerque, NM 87113-8711 | 2017-03-28 |
| 1265895486 | Nedda Fariba Karimi | Emergency Medicine | 4515 Coors Blvd Nw, Albuquerque, NM 87120-3699 | 2016-04-04 |
| 1417310764 | Justin Itty Mathew | Emergency Medicine | Department of Emergency Medicine Msc11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-04-04 |
| 1639532583 | Amanda Lauren Ventura | Emergency Medicine | Msc Emergency Medicine 1 University of New Mexico, Albuquerque, NM 87131-2364 | 2016-03-29 |
| 1083000178 | David Michael Glass | Emergency Medicine | Emergency Medicine Msc 11 6025, University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-15 |
| 1952797300 | Eleni Marie Bucuvalas | Emergency Medicine | Msc 11-6025, 1 University of New Mexico, Albuquerque, NM 87131 | 2015-04-13 |
| 1225423239 | Joseph Smith Jr. | Emergency Medicine | Msc 11 6025 University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-06 |
| 1073932471 | Kimberly Marie Ruth Pruett | Emergency Medicine | Unm Department of Emergency Medicine 1 Unm, Albuquerque, NM 87131-4700 | 2014-04-14 |
| 1538509484 | Jason S. Zeller | Emergency Medicine | Msc 11 6025 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-06-25 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87120 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.