Individual provider Active NPI

Philipp Lorenz Hannan, M.D.

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1013365675
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R75732 Issued in AZ
Practice address
3950 S Country Club Rd
Tucson, AZ 85714-2099
Phone
(520) 626-5582
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R75732 AZ Primary

Addresses

Primary practice location

3950 S Country Club Rd
Tucson, AZ 85714-2099

Mailing address

3950 S Country Club Rd
Tucson, AZ 85714-2099
Phone (520) 626-5582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190606000931 AZ Practitioner - Emergency Medicine 6305130543 Reassigns benefits to 1 organization
I20200130000442 TX Practitioner - Emergency Medicine 6305130543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Colorado School of Medicine, Denver, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

2800 E Ajo Way
Tucson, AZ 85713-6204
Phone (520) 874-2000

Hospital & facility affiliations

  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111
  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 1, 2019 Accepting new patients
Banner-University Medical Group Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Nov 21, 2019 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1013365675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142099",
            "telephone_number": "520-626-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142099",
            "telephone_number": "520-626-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN",
        "first_name": "PHILIPP",
        "middle_name": "LORENZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R75732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.