Individual provider Active NPI

Robert Dean Hanna, P.A.

  • Physician Assistant
  • Ardmore, OK
National Provider Identifier
1083601868
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
947 Issued in OK
Practice address
1505 N Commerce St
Ste 203
Ardmore, OK 73401-1859
Phone
(580) 223-6555
Fax
(580) 226-4617
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 947 OK Primary

Addresses

Primary practice location

1505 N Commerce St
Ste 203
Ardmore, OK 73401-1859

Mailing address

7800 NW 85TH Ter
Oklahoma City, OK 73132-3385

Other identifiers 1

IdentifierTypeStateIssuer
100198770AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20060615000068 OK Practitioner - Physician Assistant 2163434093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohh Physicians LLCGroup PAC ID 1759392079, 132 clinicians

Practice addresses (Care Compare)

1505 N Commerce St
Suite 203
Ardmore, OK 73401-1859
Phone (580) 223-6555

4050 W Memorial Rd
Oklahoma City, OK 73120-8382

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: rhanna21760@direct.okheart.com

Organizations & group practices 1

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 2

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1083601868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NW 85TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N COMMERCE ST",
            "address_2": "STE 203",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011859",
            "telephone_number": "580-223-6555",
            "fax_number": "580-226-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "ROBERT",
        "middle_name": "DEAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100198770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.