Individual provider Active NPI

Alexander A Hannenberg, MD

  • Anesthesiology Physician
  • Newton, MA
National Provider Identifier
1154428225
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
46014 Issued in MA
Practice address
2014 Washington St
Newton Wellesley Hospital Dept. of Anesthesia
Newton, MA 02462-1607
Phone
(617) 243-6298
Fax
(617) 243-6184
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 46014 MA Primary

Addresses

Primary practice location

2014 Washington St
Newton Wellesley Hospital Dept. of Anesthesia
Newton, MA 02462-1607

Mailing address

PO Box 414628
Physicians Accounts Receivable
Boston, MA 02241-4628
Phone (781) 449-6150

Other identifiers 1

IdentifierTypeStateIssuer
3009076MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154428225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414628",
            "address_2": "PHYSICIANS ACCOUNTS RECEIVABLE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414628",
            "telephone_number": "781-449-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "NEWTON WELLESLEY HOSPITAL DEPT. OF ANESTHESIA",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-243-6298",
            "fax_number": "617-243-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNENBERG",
        "first_name": "ALEXANDER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "46014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3009076",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.