Dallin Hazelgren, in Gilbert, AZ - Medicare Nurse Anesthetist, Certified Registered

Dallin Hazelgren, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Gilbert, Arizona. His current practice location is 1900 N Higley Rd, Gilbert, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 543-2000.

Dallin Hazelgren is licensed to practice in Arizona (license number 229177) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003592254.

Contact Information

	Dallin Hazelgren,
	1900 N Higley Rd, Gilbert, AZ 85234-1604
	(480) 543-2000
	Not Available

Map and Direction

Provider's Profile

Full Name	Dallin Hazelgren
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	1900 N Higley Rd, Gilbert, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003592254
Provider Enumeration Date: 06/23/2023
Last Update Date: 06/20/2024

Medicare PECOS Information:

PECOS PAC ID: 6103272901
Enrollment ID: I20231031002094

Medical Identifiers

Medical identifiers for Dallin Hazelgren such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003592254	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	149383 (Arizona)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	229177 (Arizona)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dallin Hazelgren allows following entities to bill medicare on his behalf.

Entity Name	Banner Hospital Based Physicians Arizona Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275889891 PECOS PAC ID: 3274782487 Enrollment ID: O20121003000752

Entity Name	Summit Anesthesia Services Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821589144 PECOS PAC ID: 3971850892 Enrollment ID: O20180724002694

Entity Name	Grand Canyon Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356822902 PECOS PAC ID: 3678824752 Enrollment ID: O20180928002378

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dallin Hazelgren is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dallin Hazelgren, 21169 E Misty Ln, Queen Creek, AZ 85142-5062 Ph: (480) 616-9814	Dallin Hazelgren, 1900 N Higley Rd, Gilbert, AZ 85234-1604 Ph: (480) 543-2000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Gilbert, AZ

Mr. Timothy Joe Carter Ii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1900 N. Higley Road, Gilbert, AZ 85234 Phone: 480-981-2400 Fax: 480-981-2407
Timothy Randall Strong, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1900 N Higley Rd, Gilbert, AZ 85234 Phone: 480-534-2600 Fax: 480-543-2586
Alisha Howe, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1833 E Everglade Ln, Gilbert, AZ 85298 Phone: 602-592-6144
Nicole Amber Dewitt, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4331 E Baseline Rd, Suite B105-625, Gilbert, AZ 85234 Phone: 480-981-0216 Fax: 480-981-1151
Brandon David Brewer, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1900 N Higley Rd, Gilbert, AZ 85234 Phone: 480-543-2600
Jennifer Baker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1900 N Higley Rd, Gilbert, AZ 85234 Phone: 480-543-2600

Dallin Hazelgren, - Medicare Nurse Anesthetist, Certified Registered in Gilbert, AZ