Individual provider Active NPI

Laurie S. Hannan-Reagan, FNP-C

  • Family Nurse Practitioner
  • Cathedral City, CA
National Provider Identifier
1043752710
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005463 Issued in CA
Practice address
67780 E Palm Canyon Dr
Cathedral City, CA 92234-5441
Phone
(760) 773-1680
NPI assigned
Nov 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005463 CA Primary

Addresses

Primary practice location

67780 E Palm Canyon Dr
Cathedral City, CA 92234-5441

Mailing address

67780 E Palm Canyon Dr
Cathedral City, CA 92234-5441
Phone (760) 773-1680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170119001624 CA Practitioner - Nurse Practitioner 5496037889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911

39950 Vista del Sol
Rancho Mirage, CA 92270-3206
Phone (760) 340-0053

67555 E Palm Canyon Dr
Cathedral City, CA 92234-5412

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Jan 17, 2017 Accepting new patients
Eisenhower Medical Center CurrentSince Jan 17, 2017 Accepting new patients

Locations

67780 E Palm Canyon Dr
Ste 100
Cathedral City, CA 92234
Phone (760) 328-1000

67555 E Palm Canyon Dr
Ste C112
Cathedral City, CA 92234
Phone (760) 773-1680

67780 E Palm Canyon Dr
Cathedral Cty, CA 92234
Phone (760) 328-1000

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

Organizations & group practices 2

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": "1478995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1043752710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67780 E PALM CANYON DR",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345441",
            "telephone_number": "760-773-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67780 E PALM CANYON DR",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345441",
            "telephone_number": "760-773-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN-REAGAN",
        "first_name": "LAURIE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-13",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

Verify at the official NPI Registry.