Martine Marie Hannallah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29532 Issued in AZ

Practice address

13991 W Grand Ave
Suite 105
Surprise, AZ 85374-3065

Phone

(623) 455-7800

Fax

(623) 455-7840

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cigna Healthcare of Arizona, Inc

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1518415397
  NPD
• Cigna Healthcare of Arizona, Inc.

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1073626404
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1194803056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 N NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858200",
            "telephone_number": "623-277-1000",
            "fax_number": "623-866-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13991 W GRAND AVE",
            "address_2": "SUITE 105",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743065",
            "telephone_number": "623-455-7800",
            "fax_number": "623-455-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNALLAH",
        "first_name": "MARTINE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596728",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Tayler Hammond, DDS, MD
• Brooke Hampton, FNP-BC
• Stephanie Funmilayo Hancock, DNP, ARNP, PMHNP-BC
• Lilias Mary Handwerk, OT
• Valerie Hanna-Patenaude, LAC
• Michael Austin Hans, PH.D.
• Jamie Hansen, COTA
• Tate Hansen, DMD
• Elizabeth Hanson
• Happy Ears Balance Center

• Internal Medicine Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.