Lori Humphrey Haseloff, MOTR/L - Medicare Occupational Therapist in Fort Worth, TX

Lori Humphrey Haseloff, MOTR/L is a medicare enrolled "Occupational Therapist" provider in Fort Worth, Texas. Her current practice location is 5417 Altamesa Blvd, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 370-6222.

Lori Humphrey Haseloff is licensed to practice in Texas (license number 113426) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053691303.

Contact Information

Lori Humphrey Haseloff, MOTR/L
5417 Altamesa Blvd,
Fort Worth, TX 76123-2804
(817) 370-6222
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameLori Humphrey Haseloff
GenderFemale
SpecialityOccupational Therapist
Location5417 Altamesa Blvd, Fort Worth, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053691303
  • Provider Enumeration Date: 08/18/2011
  • Last Update Date: 06/04/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3779983879
  • Enrollment ID: I20210610003114

Medical Identifiers

Medical identifiers for Lori Humphrey Haseloff such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053691303NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 113426 (Texas)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. Lori Humphrey Haseloff allows following entities to bill medicare on her behalf.
Provider NameLegacy Healthcare Services Inc
Provider TypePart B Supplier - Physical/occupational Therapy Group In Private Practice
Provider IdentifiersNPI Number: 1871132357
PECOS PAC ID: 2163339722
Enrollment ID: O20170201001261

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. Lori Humphrey Haseloff 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 AddressPractice Location Address
Lori Humphrey Haseloff, MOTR/L
12116 Bella Palazzo Dr,
Fort Worth, TX 76126-2134

Ph: (254) 717-8490
Lori Humphrey Haseloff, MOTR/L
5417 Altamesa Blvd,
Fort Worth, TX 76123-2804

Ph: (817) 370-6222

Reviews and Comments


Occupational Therapist in Fort Worth, TX

Ms. Mary Cathrine Mckenzie, MOT/OTR, CPRCS
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 7217 Hawkins View Dr Ste 201, Fort Worth, TX 76132
Phone: 817-479-7019    
Holly Christina Andrews,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 5316 Trail Lake Dr, Fort Worth, TX 76133
Phone: 817-292-8787    Fax: 817-789-6489
Mrs. Sue Khammar, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 4140 Tamworth Rd, Fort Worth, TX 76116
Phone: 817-386-5500    Fax: 817-386-5500
Danyelle Braelyn Huffaker, OTR
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 8000 Calmont Ave, Fort Worth, TX 76116
Phone: 817-400-2273    
Lauren Elizabeth Galipp, OT
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3840 Hulen St, Fort Worth, TX 76107
Phone: 817-335-3022    
Katherine Moos,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 5300 Altamesa Blvd, Fort Worth, TX 76133
Phone: 817-346-1800    
Diane R Alfino, O.T.
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 2500 West Fwy, Suite 100, Fort Worth, TX 76102
Phone: 888-997-2669    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.