Active NPI
Edward Jospeh Hannan, M.D.
- Surgery Physician
- Troy, NY
National Provider Identifier
1255341152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 160806
- Practice address
- 2231 Burdett Ave
Suite 130
Troy, NY 12180-2447 - Phone
- (518) 272-0171
- Fax
- (517) 271-6580
- NPI assigned
- Aug 9, 2006
- Last updated
- May 12, 2008
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 160806 | NY | Primary |
Addresses
Primary practice location
2231 Burdett Ave
Suite 130
Troy, NY 12180-2447
Mailing address
2231 Burdett Ave
Suite 130
Troy, NY 12180-2447
Phone (518) 272-0171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00890042 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160806 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital District Surgical Associates, P.L.L.C. | Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Plattsburgh, NY
- NPI 1124189782
-
- Surgery Physician
- Troy, NY
- NPI 1902914526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210550400000",
"number": "1255341152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2231 BURDETT AVE",
"address_2": "SUITE 130",
"city": "TROY",
"state": "NY",
"postal_code": "121802447",
"telephone_number": "518-272-0171",
"fax_number": "517-271-6580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2231 BURDETT AVE",
"address_2": "SUITE 130",
"city": "TROY",
"state": "NY",
"postal_code": "121802447",
"telephone_number": "518-272-0171",
"fax_number": "517-271-6580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAN",
"first_name": "EDWARD",
"middle_name": "JOSPEH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2008-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "160806",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00890042",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.