Brendan Hansen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.010368RX Issued in OH

Practice address

10500 Montgomery Rd
Montgomery, OH 45242-4402

Phone

(513) 865-1111

NPI assigned

Apr 9, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1124812458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123397",
            "telephone_number": "513-246-1964",
            "fax_number": "513-852-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3219 Clifton Ave Ste 400A",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452203027",
            "country_code": "US",
            "telephone_number": "513-246-2400",
            "fax_number": "513-861-5267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BRENDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.010368RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Grove, CRNA
• David Aaron Habib, MD
• Tiffany N Hall, MD
• Emily Morgan Hamilton, PA
• Dana Hanieh, PA-C
• Lauren Hardt, PHARMD
• Samantha Lynn Harrington
• Kellie Lynn Harris, FNP-BC
• Sarah Harris, OTR/L
• Abubaker Ahmed Hassan, MD

• Physician Assistant in Montgomery, OH
• Providers in Montgomery, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.

Verify at the official NPI Registry.