Individual provider Active NPI

David A Hanauer, MD

  • Pediatrics Physician
  • Northville, MI
National Provider Identifier
1245246289
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301084702 Issued in MI
Practice address
39901 Traditions Drive
Suite 240
Northville, MI 48158-4401
Phone
(248) 305-4400
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301084702 MI Primary

Addresses

Primary practice location

39901 Traditions Drive
Suite 240
Northville, MI 48158-4401

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
4675639MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20041209000380 MI Practitioner - Pediatric Medicine 3779549886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084702MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Pediatrics CurrentSince Feb 11, 2011 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan CurrentSince Feb 11, 2011 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

3621 S State St
#700
Ann Arbor, MI 48108

39901 Traditions Dr
Ste 240
Northville, MI 48168
Phone (248) 305-4400

Interoperability endpoints

  • Direct secure messaging: dhanauer25961@direct.med.umich.edu

Organizations & group practices 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1245246289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39901 TRADITIONS DRIVE",
            "address_2": "SUITE 240",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481584401",
            "telephone_number": "248-305-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAUER",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301084702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4675639",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.