Active NPI
Michael L Hattan, MD
- Family Medicine Physician
- South Sioux City, NE
National Provider Identifier
1124093232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 18829
- Practice address
- 3250 Plaza Dr
South Sioux City, NE 68776-3144 - Phone
- (402) 412-4220
- Fax
- (712) 494-1365
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18829 | NE | Primary |
Addresses
Primary practice location
3250 Plaza Dr
South Sioux City, NE 68776-3144
Mailing address
200 Gold Cir Ste 120
Dakota Dunes, SD 57049-5501
Phone (605) 217-0700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3929745 | Medicaid | IA | |
| 10025302400 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31287 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Family Health Care of Siouxland LLC | Family Medicine | Past | Accepting new patients |
| St Lukes Health Resources | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- michaelhattan@fhcs.allscriptsdirect.net
- mhattan128237@direct.unitypoint.org
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Family Medicine Physician
- Moville, IA
- NPI 1720278278
-
- Family Medicine Physician
- Sioux City, IA
- NPI 1528001492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1124093232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 GOLD CIR STE 120",
"city": "DAKOTA DUNES",
"state": "SD",
"postal_code": "570495501",
"telephone_number": "605-217-0700",
"fax_number": "605-217-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 PLAZA DR",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687763144",
"telephone_number": "402-412-4220",
"fax_number": "712-494-1365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTAN",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "18829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3929745",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025302400",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.