DR. PAUL M HAIDAK MD
NPI 1871612515
General Practice in Tullahoma, TN
About Dr. Paul M Haidak Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PAUL M HAIDAK MD (NPI 1871612515) is an individual general practice provider in Tullahoma, Tennessee, licensed in Tennessee (44645) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Paul M Haidak Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Paul Haidak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tullahoma, TN 37388
- Reassigned Medicare billing, Tennessee enrollment
- 110 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Paul Haidak's NPI number?
The NPI number for Paul Haidak is 1871612515. It was assigned to this individual provider in the NPPES registry on March 27, 2007.
Where is Paul Haidak located?
Paul Haidak practices at 105 Ledford Mill Rd Suite B, Tullahoma, TN 37388. The listed phone number is (931) 841-3311.
What is Paul Haidak's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Paul Haidak enrolled in Medicare?
Yes. Paul Haidak is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Paul Haidak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Paul Haidak reassigns Medicare benefits to Amg-Southern Tennessee LLC (Tullahoma, TN). The 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 Paul Haidak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Paul Haidak was last updated on March 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. Paul M Haidak, MD · NPI 1871612515
General Practice physician in Tullahoma, Tennessee. Individual provider, active in the CMS NPPES registry since March 27, 2007.
## Identity
- **NPI:** 1871612515 (Entity type: Individual)
- **Enumerated:** March 27, 2007
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 44645 (Tennessee)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 105 LEDFORD MILL RD, SUITE B, Tullahoma, TN 37388-8261
- **Phone:** (931) 841-3311 · **Fax:** (931) 841-3314
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Amg-Southern Tennessee LLC (NPI 1619605607, Tullahoma, TN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 15, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1871612515) · Data from the CMS NPPES public registry.