NPIMap

Individual provider Active NPI

Dalia Hanna, MD

  • Family Medicine Physician
  • Morganville, NJ
National Provider Identifier
1053402479
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07951000 Issued in NJ
Practice address
436 Route 79 Ste 11
Morganville, NJ 07751-9783
Phone
(732) 263-7970
Fax
(732) 263-7971
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA07951000 NJ Primary

Addresses

Primary practice location

436 Route 79 Ste 11
Morganville, NJ 07751-9783

Mailing address

436 Route 79 Ste 11
Morganville, NJ 07751-9783
Phone (732) 263-7970

Other identifiers 1

IdentifierTypeStateIssuer
0100692MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000084 NJ Practitioner - Family Practice 1052321676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

213 Main St
Matawan, NJ 07747-3221
Phone (732) 566-2363

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Kenneth Faistl, MD,PA Family Medicine PastSince Mar 13, 2009 Accepting new patients
Centrastate Medical Associates PC Family Medicine PastSince Sep 26, 2016 Accepting new patients
Vincent Destasio DO LLC Family Medicine Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

213 Main St
Matawan, NJ 07747
Phone (732) 566-2363

436 State Route 79
Ste 11
Morganville, NJ 07751
Phone (732) 263-7970

429 Highway 79
Morganville, NJ 07751

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 5

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 8

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1053402479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 ROUTE 79 STE 11",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077519783",
            "telephone_number": "732-263-7970",
            "fax_number": "732-263-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 ROUTE 79 STE 11",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077519783",
            "telephone_number": "732-263-7970",
            "fax_number": "732-263-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "DALIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07951000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100692",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganville, NJ

Sources for this page

Verify at the official NPI Registry.