MICHAEL D HAZELBERG (DO) – Family Medicine Physician, NPI 1013051069

MICHAEL D HAZELBERG (DO) is a healthcare provider. based in Mayville, Wisconsin. specializing in Family Medicine Physician. They hold the professional credentials DO. They hold a License No. 50451-21 (WI). The NPI Number for MICHAEL D HAZELBERG (DO) is 1013051069

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL D HAZELBERG (DO)
NPI
1013051069
Phone
(920) 387-7500
Address
360 S Mountin Dr
Enumeration Date
16 February 2007
Last Update Date
24 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4142550300
Graduation Year
2005 (21 years ago)
PAC ID
0547320525
Group Practice PAC ID
1658696729
Professional Enrollment ID
I20081120000457
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for MICHAEL D HAZELBERG (DO)

  • 360 S Mountin Dr

    Mayville, WI 530501498

    Phone: (920) 387-7500

    Fax: (920) 387-7596

    Type: Location

  • 2514 S 102ND ST STE 160

    WEST ALLIS, WI 532272142

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081120000457IFamily PracticeWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53050)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658696729View full group profile

Reviews

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Frequently asked questions

Can I cross-check MICHAEL D HAZELBERG (DO) using NPI 1013051069?
NPI 1013051069 belongs to MICHAEL D HAZELBERG (DO); compare other details if you need extra assurance.
Active or inactive — what applies to MICHAEL D HAZELBERG (DO)?
You should see MICHAEL D HAZELBERG (DO) as active in CMS-hosted NPPES data.
What clinical focus is listed for MICHAEL D HAZELBERG (DO)?
At a glance, MICHAEL D HAZELBERG (DO) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is MICHAEL D HAZELBERG (DO) located near Mayville?
MICHAEL D HAZELBERG (DO) currently maps to Mayville, Wisconsin in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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