Individual provider Active NPI

Matthew Alan Hansen

  • Internal Medicine Physician
  • Everett, WA
National Provider Identifier
1104117399
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60450630 Issued in WA
Practice address
1321 Colby Ave
Everett, WA 98201-1665
Phone
(425) 261-2000
NPI assigned
Apr 22, 2011
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD60450630 WA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD60450630 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Everett, WA 98201-1665

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other practice location 1

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 259-0966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140620002114 WA Practitioner - Internal MedicinePractitioner - Hospitalist 0547494973 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Saint Louis University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60450630WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Feb 15, 2017 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Providence Health & Services - Wa CurrentSince Feb 15, 2017 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: mhansen13842@direct.tecmc.com
  • Direct secure messaging: mhansen435025@wm.providencedirect.org

Organizations & group practices 6

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 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": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1104117399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014918",
            "country_code": "US",
            "telephone_number": "425-259-0966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-22",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60450630",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60450630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.