Individual provider Active NPI

Randal Linn Hanson, O.D.

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1194945717
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3118 Issued in FL
Practice address
4600 Summerlin Road
Suite C4
Fort Myers, FL 33919-3003
Phone
(239) 936-2121
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3118 FL Primary

Addresses

Primary practice location

4600 Summerlin Road
Suite C4
Fort Myers, FL 33919-3003

Mailing address

711 SW 3Rd CT
Cape Coral, FL 33991-2586
Phone (239) 823-2576

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909000902 FL Practitioner - Optometry 7012032303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4600 Summerlin Rd
C4
Fort Myers, FL 33919-3003
Phone (239) 936-2121

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3118FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Hanson & Associates PA CurrentSince May 7, 2010 Accepting new patients

Locations

4600 Summerlin Rd
Ste C4
Fort Myers, FL 33919
Phone (239) 936-2121

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1194945717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SW 3RD CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912586",
            "telephone_number": "239-823-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 SUMMERLIN ROAD",
            "address_2": "SUITE C4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193003",
            "telephone_number": "239-936-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "RANDAL",
        "middle_name": "LINN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.