NPIMap

Individual provider Active NPI

John R Hansen, MD

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1073521977
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0429103 Issued in KS
Practice address
12330 Metcalf Ave
Suite 500
Overland Park, KS 66213-1324
Phone
(913) 491-1616
Fax
(913) 491-8061
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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 0429103 KS Primary

Addresses

Primary practice location

12330 Metcalf Ave
Suite 500
Overland Park, KS 66213-1324

Mailing address

12330 Metcalf Ave
Suite 500
Overland Park, KS 66213-1324
Phone (913) 491-1616

Other identifiers 5

IdentifierTypeStateIssuer
100400020AMedicaidKS
100400020BMedicaidKS
101157OtherKSBLUE CROSS BLUE SHIELD
D05F416OtherMEDICARE
7703264OtherKSAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JOHN.HANSEN@hca2.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20070814000629 KS Practitioner - Family Practice 5092712455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Health Medical Group of Overland Park, LLCGroup PAC ID 0244425841, 8 clinicians

Practice addresses (Care Compare)

13801 Metcalf Ave
Suite 100
Overland Park, KS 66223-3092
Phone (913) 491-1616

5721 W 119TH St
Overland Park, KS 66209-3722
Phone (913) 498-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0429103KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Medical Group of Overland Park, LLC Family Medicine CurrentSince Nov 1, 2010 Accepting new patients
Menorah Urgent Care, LLC Past Accepting new patients

Locations

421 S Maple St
Garnett, KS 66032
Phone (785) 204-7105

12330 Metcalf Ave
Ste 500
Overland Park, KS 66213
Phone (913) 317-3170

13801 Metcalf Ave
Ste 100
Overland Park, KS 66223
Phone (913) 491-1616

7935 W 151st St
Overland Park, KS 66223
Phone (913) 814-3788

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kansas Palliative & Hospice CareShawnee, KS, CCN 171557 Hospice Contracted Managing Employee Sep 2, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1073521977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 METCALF AVE",
            "address_2": "SUITE 500",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-491-1616",
            "fax_number": "913-491-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 METCALF AVE",
            "address_2": "SUITE 500",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-491-1616",
            "fax_number": "913-491-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0429103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100400020A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100400020B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "101157",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "D05F416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7703264",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JOHN.HANSEN@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12330 Metcalf Ave",
            "address_2": "SUITE 500",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662131324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.