Individual provider Active NPI

Peter Yousef Hannoush, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Hackensack, NJ
National Provider Identifier
1184760811
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MA65456 Issued in NJ
Practice address
380 Sutton Ave
Hackensack, NJ 07601-1829
Phone
(201) 488-8766
Fax
(201) 488-8646
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

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
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MA65456 NJ Primary

Addresses

Primary practice location

380 Sutton Ave
Hackensack, NJ 07601-1829

Mailing address

380 Sutton Ave
Hackensack, NJ 07601-1829
Phone (201) 488-8766

Other identifiers 1

IdentifierTypeStateIssuer
7331100MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050616001117 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 0547204802 Practice locations: Hackensack, NJ

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

380 Sutton Ave
Hackensack, NJ 07601-1829
Phone (201) 488-8766

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
25.67 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
85.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA65456NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatric Foot and Ankle Surgeon, LLC PastSince Dec 24, 2008 Accepting new patients

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 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184760811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUTTON AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011829",
            "telephone_number": "201-488-8766",
            "fax_number": "201-488-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SUTTON AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011829",
            "telephone_number": "201-488-8766",
            "fax_number": "201-488-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNOUSH",
        "first_name": "PETER",
        "middle_name": "YOUSEF",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "MA65456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7331100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.