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DR. ANN HATHAWAY MD
NPI 1093893752
Family Medicine in San Rafael, CA

Active since November 01, 2006Opted out of Medicare · through Jan 1, 2028
25 MITCHELL BLVD, #3, SAN RAFAEL, CA 94903(415) 499-0966(415) 446-0118 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Ann Hathaway Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANN HATHAWAY MD (NPI 1093893752) is an individual family medicine provider in San Rafael, California, licensed in California (G42615) and active in the NPI registry since November 2006. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1093893752
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. ANN HATHAWAYCredential: MD
Location Address25 MITCHELL BLVD, #3San Rafael, CA 94903-2007
Mailing Address48 Mahogany DrSan Rafael, CA 94903-3132 · (415) 472-6849 · Fax (415) 446-0118
Phone(415) 499-0966
Fax(415) 446-0118
Sole ProprietorYes
Enumeration DateNovember 1, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1093893752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · G42615
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
25 MITCHELL BLVD, San Rafael, CA 94903
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Other Identifiers 3

Medicare ID-Type Unspecified00G426151CA
Medicaid00G426151CA
Medicare UPINF44320CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Ann Hathaway Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2016 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2016
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.67 typical visit price
range $69.07 – $202.63
Typical copayment $26.16 (range $17.26 – $50.65)
Most-billed visit code 99203
Established Patient
$119.61 typical visit price
range $23.44 – $166.64
Typical copayment $29.90 (range $5.86 – $41.66)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JUDY LANE N.P., R.N.
Nurse Practitioner (Adult Health)
25 MITCHELL BLVD, SUITE 8
SAN RAFAEL, CA 94903
Marin County (415) 472-2343
SEEMIN ANNA DALLENBACH D.C.
Chiropractor
25 MITCHELL BLVD, SUITE 8
SAN RAFAEL, CA 94903
Marin County (415) 472-2343
MS. KARILEE HALO SHAMES PHD, RN, A-HNC
Registered Nurse (Psychiatric/Mental Health)
25 MITCHELL BLVD, SUITE 8
SAN RAFAEL, CA 94903
Marin County (415) 472-2343
DR. RICHARD L. SHAMES MD
Preventive Medicine (Public Health & General Preventive Medicine)
25 MITCHELL BLVD, #8
SAN RAFAEL, CA 94903
Marin County (415) 472-2343
DR. ELSON M HAAS M.D.
Allergy & Immunology
25 MITCHELL BLVD, SUITE 8
SAN RAFAEL, CA 94903
Marin County (415) 472-2343
ESSENTIAL BALANCE PHYSICAL THERAPY, INC
Physical Therapist
25 MITCHELL BLVD, SUITE 2
SAN RAFAEL, CA 94903
Marin County (415) 924-5700
LAUREN IONE FRIEDEMAN DPT
Physical Therapist
25 MITCHELL BLVD, SUITE 2
SAN RAFAEL, CA 94903
Marin County (415) 924-5700
DR. THOMAS REECE DO
Neuromusculoskeletal Medicine, Sports Medicine
25 MITCHELL BLVD
SAN RAFAEL, CA 94903
Marin County (415) 472-2343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ann Hathaway's NPI number?

The NPI number for Ann Hathaway is 1093893752. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Ann Hathaway located?

Ann Hathaway practices at 25 Mitchell Blvd #3, San Rafael, CA 94903. The listed phone number is (415) 499-0966.

What is Ann Hathaway's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ann Hathaway enrolled in Medicare?

No. Ann Hathaway has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ann Hathaway was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.