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JACK HAZAN LLC
NPI 1508639279
Community/Behavioral Health in Miami Beach, FL

Active since November 03, 2023
1504 BAY RD APT 2003, MIAMI BEACH, FL 33139(646) 692-0761 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 2, 2026, Jan 5, 2024, Dec 5, 2023 and 1 more (4 updates tracked since 2023).

About Jack Hazan Llc NPPES

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

JACK HAZAN LLC (NPI 1508639279) is a healthcare organization registered as a community/behavioral health in Miami Beach, Florida and active in the NPI registry since November 2023. The organization maintains 2 additional practice locations and lists Jack Hazan, Owner, as its authorized official.

NPPES Registry Identity

NPI1508639279
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameJACK HAZAN LLC
Location Address1504 BAY RD APT 2003Miami Beach, FL 33139-3277
Mailing Address401 W 25th St Apt 13cNew York, NY 10001-6575 · (917) 453-9306
Phone(646) 692-0761
Organization SubpartNo
Authorized OfficialJack HazanOwner · (917) 453-9306
Enumeration DateNovember 3, 2023
Last NPPES UpdateApril 2, 20264 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1508639279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
1504 BAY RD APT 2003, Miami Beach, FL 33139
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Secondary Practice Locations 2

Location 116 E 41st St Ste 5CNew York, NY 10017-6217 · Phone (646) 692-0761
Location 2401 W 25th St Apt 13CNew York, NY 10001-6575 · Phone (917) 453-9306

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Hazan Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jack Hazan LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jack Hazan, LMHC , CSAT
Mental Health Counselor
NPI 1376022079
1504 BAY RD APT 2003
Miami Beach, FL 33139
(917) 453-9306
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Jack Hazan LLC's NPI number?

The NPI number for Jack Hazan LLC is 1508639279. It was assigned to this organization in the NPPES registry on November 3, 2023.

Where is Jack Hazan LLC located?

Jack Hazan LLC is located at 1504 Bay Rd Apt 2003, Miami Beach, FL 33139. The listed phone number is (646) 692-0761.

What is Jack Hazan LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Jack Hazan LLC enrolled in Medicare?

Yes. Jack Hazan LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jack Hazan LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Jack Hazan LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Jack Hazan LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Texas list Jack Hazan LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Hazan LLC was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.