Individual provider Active NPI

Edward Hannoush, MD

  • Surgery Physician
  • Hartford, CT
National Provider Identifier
1235387457
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
050765 Issued in CT
Practice address
85 Seymour St
Suite 415
Hartford, CT 06106-5501
Phone
(860) 246-2071
Fax
(860) 524-2650
NPI assigned
Aug 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 050765 CT Primary

Addresses

Primary practice location

85 Seymour St
Suite 415
Hartford, CT 06106-5501

Mailing address

85 Seymour St
Suite 415
Hartford, CT 06106-5501
Phone (860) 246-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120615000286 CT Practitioner - General Surgery 0244494664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

11 S Rd
Suite 130
Farmington, CT 06032-2483
Phone (860) 224-5161

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)18
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050765CTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Surgery CurrentSince Aug 1, 2013 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Surgery CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

11 South Rd
Ste 130
Farmington, CT 06032
Phone (860) 224-5360

330 Western Blvd
Glastonbury, CT 06033
Phone (860) 524-4566

85 Seymour St
Ste 415
Hartford, CT 06106
Phone (860) 249-2071

85 Seymour St
Ste 700
Hartford, CT 06106
Phone (860) 246-2277

256 N Main St
Manchester, CT 06042
Phone (860) 646-8595

1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 224-5305

Interoperability endpoints

  • Direct secure messaging: edward.hannoush@xdr.hhchealthdirect.org

Organizations & group practices 3

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 2

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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1235387457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 415",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-246-2071",
            "fax_number": "860-524-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 415",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-246-2071",
            "fax_number": "860-524-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNOUSH",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "050765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.