Douglas Alan Hansen, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

74455-20 Issued in WI

Practice address

801 York St
Manitowoc, WI 54220-4630

Phone

(920) 663-9008

Fax

(920) 684-1439

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WA, WI2 enrollments

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 2

Specialty

Dermatology

Education

University of Washington School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: douglashansen@forefrontdermatology.emadirect

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Appleton, WI
  • NPI 1083768253

  Dermatopathology

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Integrity Pathology LLC

  • Anatomic Pathology Physician
  • Medina, WA
  • NPI 1366871402
  NPD Authorized official
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Sheboygan, WI
  • NPI 1336406081
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904

  Dermatopathology

  NPD (past)
• Puget Sound Institute of Pathology PLLC

  • Anatomic Pathology Physician
  • Seattle, WA
  • NPI 1992787030
  NPD (past)
• Puget Sound Institute of Pathology, PLLC

  • Clinical Medical Laboratory
  • Seattle, WA
  • NPI 1720392806
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1124061619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11211 120th Ave Ste A009B",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581703",
            "country_code": "US",
            "telephone_number": "262-283-5333",
            "fax_number": "262-912-0137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "WI",
            "license": "74455-20",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME122758",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD21809",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WI",
            "license": "74455-20",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00034088",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "74455-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DouglasHansen@forefrontdermatology.emadirect",
            "affiliation": "N",
            "address_1": "11211 120th Ave Ste A009B",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DouglasHansen@forefrontdermatology.emadirect",
            "affiliation": "N",
            "address_1": "801 York St",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542204630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tanya Hall
• Lou Hang
• Hanger Prosthetics & Orthotics East Inc
• Bethany Hannon, MA, LAT
• Chris John Hansen, DDS, FAGD
• Judith Hanson
• Peter Michael Hanson, DDS
• Beverly Faye Hardiman
• Harmony Personal Home Care, LLC
• Kenneth Martin Hartenian, DMD

• Anatomic Pathology & Clinical Pathology Physician in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.

Verify at the official NPI Registry.