Peter Samir Hanna, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3800 Issued in CT

Practice address

64 Robbins St
Waterbury, CT 06708

Phone

(704) 340-5079

NPI assigned

Aug 28, 2016

Last updated

Jul 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Mr. Boutros S Badawi Former name

Medicare fee-for-service enrollment

Enrolled in WV, CT, NY3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: peter.hanna@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment Care Compare group
• Emergency Physicians of Connecticut PC

  • Emergency Medicine Physician
  • Waterbury, CT
  • NPI 1902278906
  Medicare reassignment
• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment
• Allied West Virginia Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Huntington, WV
  • NPI 1487109104
  Medicare reassignment
• Beckley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Beckley, WV
  • NPI 1376757674
  Medicare reassignment
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment
• Greenbrier Emergency Services, Inc.

  • Emergency Medicine Physician
  • Gassaway, WV
  • NPI 1568401461
  Medicare reassignment
• Uconn Health Community Network Medical Group, Inc.

  • Family Medicine Physician
  • Waterbury, CT
  • NPI 1548119522

  Medical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531008000000",
    "number": "1003362351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 4TH ST APT A",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105733",
            "telephone_number": "704-340-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "704-340-5079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 MacCorkle Ave SE Lbby",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041294",
            "country_code": "US",
            "telephone_number": "304-388-4172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE Lbby",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041294",
            "country_code": "US",
            "telephone_number": "304-388-4172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Seaside Ave",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064604603",
            "country_code": "US",
            "telephone_number": "203-876-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Massena",
            "state": "NY",
            "postal_code": "136621056",
            "country_code": "US",
            "telephone_number": "315-764-1711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Old New Milford Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "CT",
            "postal_code": "068042430",
            "country_code": "US",
            "telephone_number": "203-775-6205",
            "fax_number": "203-775-2373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "PETER",
        "middle_name": "SAMIR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2018-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1990",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3800",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "3800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOUTROS",
            "last_name": "BADAWI",
            "middle_name": "S",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Martina Hammond, CNA
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• Coretta Lee Hanks
• Kevin Hanley
• Elisheva Yehudit Hanover, MSW
• Brian Hanrahan
• Sydney Hardwick
• Melinda Marie Hardy, MSW,BS,LMSW
• Lauren Harkins, BA

• Medical Physician Assistant in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.