Individual provider Active NPI

Wade W. Han, M.D.

  • Otolaryngology Physician
  • Kissimmee, FL
National Provider Identifier
1184638389
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME75769 Issued in FL
Practice address
3270 Greenwald Way N
Kissimmee, FL 34741-0728
Phone
(407) 944-3340
Fax
(407) 944-3343
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME75769 FL Primary

Addresses

Primary practice location

3270 Greenwald Way N
Kissimmee, FL 34741-0728

Mailing address

PO Box 771989
Orlando, FL 32877-1989
Phone (407) 944-3340

Other identifiers 1

IdentifierTypeStateIssuer
254295100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000469 FL Practitioner - Otolaryngology 5294719589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Perelman School of Med at the University of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3270 Greenwald Way N
Kissimmee, FL 34741-0728

7327 Stonerock Cir
Orlando, FL 32819-8002
Phone (407) 944-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75769FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wade W Han MD PA Otolaryngology CurrentSince Jun 15, 2004 Accepting new patients

Locations

201 Hilda St
Ste 32
Kissimmee, FL 34741
Phone (407) 944-3340

3270 Greenwald Way N
Kissimmee, FL 34741
Phone (407) 944-3340

7327 Stonerock Cir
Fl Ent
Orlando, FL 32819
Phone (407) 944-3340

7327 Stonerock Cir
Orlando, FL 32819
Phone (407) 944-3340

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFGIBA/Endpoint/GFGIBA

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 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1184638389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771989",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328771989",
            "telephone_number": "407-944-3340",
            "fax_number": "407-944-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-944-3340",
            "fax_number": "407-944-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "WADE",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME75769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254295100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.