Individual provider Active NPI

Luke Robert Hansen, PSY,D

  • Cognitive & Behavioral Psychologist
  • Marshalltown, IA
National Provider Identifier
1114991965
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
00939 Issued in IA
Practice address
9 N 4TH Ave
Marshalltown, IA 50158-1836
Phone
(641) 752-1585
Fax
(641) 752-9665
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 00939 IA Primary

Addresses

Primary practice location

9 N 4TH Ave
Marshalltown, IA 50158-1836

Mailing address

9 N 4TH Ave
Marshalltown, IA 50158-1836
Phone (641) 752-1585

Other identifiers 7

IdentifierTypeStateIssuer
05823OtherIAMEDICARE
321119OtherIAVALUE OPTIONS
05823OtherIABCBS
240194OtherIAMIDLANDS CHOICE
IA0137OtherIAJOHN DEERE/UBH
080381OtherIAHEALTH ALLIANCE
0058230MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000126 IA Practitioner - Clinical Psychologist 0840479739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1340 Blairs Ferry Rd
Unit a
Hiawatha, IA 52233-1900
Phone (319) 398-6575

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00939IAMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Jan 4, 2011 Accepting new patients
Mercy Medical Center CurrentSince Jan 4, 2011 Accepting new patients
Center Associates Cognitive & Behavioral PastSince Sep 19, 2022 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1114991965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 N 4TH AVE",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501581836",
            "telephone_number": "641-752-1585",
            "fax_number": "641-752-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N 4TH AVE",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501581836",
            "telephone_number": "641-752-1585",
            "fax_number": "641-752-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "LUKE",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PSY,D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IA",
            "license": "00939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "05823",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "321119",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05823",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "240194",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE/UBH",
            "identifier": "IA0137",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "080381",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058230",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

Verify at the official NPI Registry.