NPIMap

Individual provider Active NPI

Michelle Nyberg Hanson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Alexandria, MN
National Provider Identifier
1235148164
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
37636 Issued in MN
Practice address
111 17TH Ave E
Alexandria, MN 56308-5273
Phone
(320) 762-1511
Fax
(320) 762-6101
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 37636 MN Primary

Addresses

Primary practice location

111 17TH Ave E
Alexandria, MN 56308-5273

Mailing address

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000971 MN Practitioner - Pathology 1850375437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Hospital & facility affiliations

  • Alomere Health Hospital, Alexandria, MN, CCN 240030
  • St Gabriels Hospital Hospital, Little Falls, MN, CCN 241370
  • Stevens Community Medical Center Inc Hospital, Morris, MN, CCN 241363
  • Astera Health Hospital, Wadena, MN, CCN 241354

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Midsota Plastic and Reconstructive Surgeons PA Past Accepting new patients
Three Rivers Pathology PA Past Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

Interoperability endpoints

  • Direct secure messaging: mhanson196316@direct.centracare.com

Organizations & group practices 5

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 8

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1235148164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085273",
            "telephone_number": "320-762-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085273",
            "telephone_number": "320-762-1511",
            "fax_number": "320-762-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MICHELLE",
        "middle_name": "NYBERG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "37636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.