Individual provider Active NPI

Ganan Hahn, PA

  • Physician Assistant
  • Belleville, IL
National Provider Identifier
1184337032
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
08501028 Issued in IL
Practice address
4700 Memorial Dr Ste 340
Belleville, IL 62226-5373
Phone
(618) 234-9884
Fax
(618) 235-9020
NPI assigned
Jan 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 08501028 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X MO

Addresses

Primary practice location

4700 Memorial Dr Ste 340
Belleville, IL 62226-5373

Mailing address

660 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8512
Phone (314) 448-3791

Other practice location 1

3437 Caroline St
Saint Louis, MO 63104-1111
Phone (314) 977-2570

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423001585 IL Practitioner - Physician Assistant 6103265202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

4700 Memorial Dr
Belleville, IL 62226-5373

Hospital & facility affiliations

  • Memorial Hospital Hospital, Belleville, IL, CCN 140185
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
08501028ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince May 1, 2024 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4700 Memorial Dr
Ste 300
Belleville, IL 62226
Phone (618) 234-9884

4700 Memorial Dr
Ste 350
Belleville, IL 62226
Phone (618) 235-7065

4700 Memorial Dr
Ste 340
Belleville, IL 62226
Phone (618) 234-9884

1414 Cross St
Ste 110
Shiloh, IL 62269
Phone (618) 234-9884

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1184337032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418512",
            "telephone_number": "314-448-3791",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR STE 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265373",
            "telephone_number": "618-234-9884",
            "fax_number": "618-235-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3437 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041111",
            "country_code": "US",
            "telephone_number": "314-977-2570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAHN",
        "first_name": "GANAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "08501028",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4700 Memorial Dr Ste 340",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.