Active NPI
Bonnie McManamon Hanson
- Physician Assistant
- Metairie, LA
National Provider Identifier
1164823977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.200729
- Practice address
- 4228 Houma Blvd Ste 130
Metairie, LA 70006-3003 - Phone
- (504) 454-2222
- Fax
- (504) 454-2388
- NPI assigned
- Sep 11, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.200729 | LA | Primary |
Addresses
Primary practice location
4228 Houma Blvd Ste 130
Metairie, LA 70006-3003
Mailing address
4200 Houma Blvd
Medical Staff Services
Metairie, LA 70006-2429
Phone (504) 503-6781
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08404301 | Medicaid | MS | |
| 2380613 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150129001197 | LA | Practitioner - Physician Assistant | 5597089284 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthcare Plus Limited Liability Company
Practice addresses (Care Compare)
Metairie, LA 70001
Phone (769) 243-6141
Hospital & facility affiliations
- Covenant Home Health, LLC
- Panola Medical Center
- Ochsner Medical Center Acute
- Bridgepoint Continuing Care Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.200729 | LA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Metairie Physician Services Inc. | Past | Accepting new patients |
Locations
1514 Jefferson Hwy
New Orleans, LA 70121
Organizations & group practices 6
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.
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- Covington, LA
- NPI 1013747039
-
- General Practice Physician
- Marrero, LA
- NPI 1336348382
-
- Internal Medicine Physician
- Metairie, LA
- NPI 1801233648
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Hospital
- Marrero, LA
- NPI 1407207632
Long-term care hospital
-
- Long Term Care Hospital
- Metairie, LA
- NPI 1881162337
Long-term care hospital
-
- Home Health Agency
- Metairie, LA
- NPI 1568885523
-
- Rural Acute Care Hospital
- Batesville, MS
- NPI 1053873307
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1164823977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 HOUMA BLVD",
"address_2": "MEDICAL STAFF SERVICES",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700062429",
"telephone_number": "504-503-6781",
"fax_number": "504-503-5667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4228 HOUMA BLVD STE 130",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700063003",
"telephone_number": "504-454-2222",
"fax_number": "504-454-2388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "BONNIE",
"middle_name": "MCMANAMON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-11",
"last_updated": "2022-12-02",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PA.200729",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08404301",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2380613",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.