Active NPI
Susan Janelle Hanson, PA-C
- Medical Physician Assistant
- Fargo, ND
National Provider Identifier
1114966751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PAC0312
- Practice address
- 1707 Gold Dr
Fargo, ND 58103-6413 - Phone
- (701) 280-2033
- Fax
- (701) 232-5578
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PAC0312 | ND | Primary |
Addresses
Primary practice location
1707 Gold Dr
Fargo, ND 58103-6413
Mailing address
4450 31St Ave S
Ste 102
Fargo, ND 58104-4557
Phone (701) 280-2033
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11277 | Medicaid | ND | |
| 2303752 | Other | AMERICAS PPO | |
| 24823 | Other | ND | ND BLUE SHIELD |
| Q25266 | Other | ND | ND WORKERS COMP |
| P50714 | Other | HEALTH PARTNERS | |
| 01-19213 | Other | MEDICA | |
| HN10910428 | Other | PREFERRED ONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Maryland School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4450 31St Ave S
Suite 102
Fargo, ND 58104-4557
Phone (701) 280-2033
Hospital & facility affiliations
- Ethos Home Health
- Essentia Health
- Sanford Medical Center Fargo
Merit-based Incentive Payment System (MIPS)
- Final score
- 65.7 of 100
- Quality
- 100
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 69.01
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0312 | ND | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joshua G Yorgason MD PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Fargo, ND
- NPI 1144313743
-
- Otolaryngology Physician
- Bismarck, ND
- NPI 1407390263
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Fargo, ND
- NPI 1043636723
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1215125463
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1114966751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4450 31ST AVE S",
"address_2": "STE 102",
"city": "FARGO",
"state": "ND",
"postal_code": "581044557",
"telephone_number": "701-280-2033",
"fax_number": "701-232-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 GOLD DR",
"city": "FARGO",
"state": "ND",
"postal_code": "581036413",
"telephone_number": "701-280-2033",
"fax_number": "701-232-5578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "SUSAN",
"middle_name": "JANELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ND",
"license": "PAC0312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11277",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "2303752",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND BLUE SHIELD",
"identifier": "24823",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND WORKERS COMP",
"identifier": "Q25266",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "P50714",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-19213",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "HN10910428",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.