Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Molly Anne Hazelbaker, PA-C

Individual provider Physician Assistant · NPI 1780287748

Molly Anne Hazelbaker, PA-C is a Physician Assistant in Crestview Hills, Kentucky. Qualified in 2020, 6 years ago. Practices with Tri State Urologic Services PSC Inc, a 74-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
6
Licensed in
OH
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

350 Thomas More Pkwy
Crestview Hills, KY 41017-5465
Phone: (859) 363-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006634 (OH)

Record details

NPI number1780287748
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 20, 2020
Last updated in NPPESNovember 20, 2020
Certification dateNovember 20, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Tri State Urologic Services Psc Inc — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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