Daniel M. Hale, PA-C
Individual provider Active NPI Physician Assistant · Fort Leavenworth, KS
NPI 1003244641 · NPPES record last updated Oct 1, 2025
Key facts
- NPI
- 1003244641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 550 Pope Ave
Fort Leavenworth, KS 66027-2332 - Phone
- (913) 684-6000
- NPI assigned
- Oct 16, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240401002500 | IL | Practitioner - Physician Assistant | 5698113330 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.009830 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renew Wound Care of Illinois PLLC | Current |
Accepting new patients |
Locations
1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | ||
| Physician Assistant | 363A00000X | 085.009830 | IL |
Addresses
Primary practice location
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Mailing address
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6000
Other practice location 1
4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 233-7750
Other practice location 2
1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-1000
Other practice location 3
7530 McGeorge Rd
Milford, KS 66514-8983
Phone (785) 240-4318
Other providers in Fort Leavenworth, KS
- Maria Grisel Gregory
- Kristie Michelle Grenier
- Veronica A. Griffith
- Shari Angelique Guinn
- Kristie L Hager
- Rachel Elena Haley
- Leonard L Hall
- Gregory Hare
- Lisa M Harmon
- Wendy Harmon
All providers in Fort Leavenworth, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.