Mark Hanna

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86170043 Issued in NJ

Practice address

35 Arden Rd
Old Bridge, NJ 08857-1829

Phone

(732) 589-2266

NPI assigned

Dec 30, 2024

Last updated

Dec 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1073322566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 ARDEN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571829",
            "telephone_number": "732-589-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86170043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hackensack Meridian Ambulatory Care, Inc (JFK Advanced Medical Imaging of Old Bridge)
• Hackensack Meridian Ambulatory Care, Inc (HMH Pharmacy at Old Bridge Medical Center)
• Hackensack Meridian Outpatient Services, Inc. (Hackensack Meridian Imaging Old Bridge)
• Alexandra J. Hagins, LCSW
• Samantha Hands, OTR/L
• Haodong Song MD PC
• Harbor Dental Associates LLC
• Susanna Harutyunyan, RPH
• Mohamed H Hasham, MD
• Hassan Medical Pain Relief and Wellness Center

• Registered Dietitian in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.