Active NPI
Derek Hanson, PT
- Specialist
- Lynbrook, NY
National Provider Identifier
1235500554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 039113-1
- Practice address
- 225 Merrick Road
Lynbrook, NY 11563-2519 - Phone
- (516) 599-8734
- Fax
- (516) 599-8730
- NPI assigned
- Oct 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 039113-1 | NY | Primary |
Addresses
Primary practice location
225 Merrick Road
Lynbrook, NY 11563-2519
Mailing address
225 Merrick Road
Lynbrook, NY 11563-2519
Phone (516) 599-8734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039113-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1235500554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 MERRICK ROAD",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115632519",
"telephone_number": "516-599-8734",
"fax_number": "516-599-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MERRICK ROAD",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115632519",
"telephone_number": "516-599-8734",
"fax_number": "516-599-8730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "DEREK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "039113-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.