Individual provider Active NPI

Maria Madelyn Hannaway, MD

  • Dermatology Physician
  • Paoli, PA
National Provider Identifier
1265843304
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD463696 Issued in PA
Practice address
21 Industrial Blvd Ste 101
Paoli, PA 19301-1610
Phone
(610) 647-4161
NPI assigned
May 12, 2014
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD463696 PA Primary

Addresses

Primary practice location

21 Industrial Blvd Ste 101
Paoli, PA 19301-1610

Mailing address

176 S New Middletown Rd Ste 203
Media, PA 19063-5255
Phone (610) 566-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180817001561 PA Practitioner - Dermatology 6103175583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.52 of 100Reported as group
Quality
87.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Dermatology Partners Inc Dermatology CurrentSince Nov 1, 2022 Accepting new patients
Aesthetic Dermatology Associates, PC Dermatology CurrentSince Nov 26, 2023 Accepting new patients

Locations

1950 Street Rd
Ste 100
Bensalem, PA 19020
Phone (215) 639-7546

258 Ben Franklin Hwy E
Birdsboro, PA 19508
Phone (610) 288-2918

176 S New Middletown Rd
Ste 203
Media, PA 19063
Phone (610) 566-7300

21 Industrial Blvd
Ste 101
Paoli, PA 19301
Phone (610) 251-0300

633 W Germantown Pike
Ste 103
Plymouth Meeting, PA 19462

Interoperability endpoints

  • Direct secure messaging: mhannaway@pennderm.emadirect.md

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1265843304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 S NEW MIDDLETOWN RD STE 203",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635255",
            "telephone_number": "610-566-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 INDUSTRIAL BLVD STE 101",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011610",
            "telephone_number": "610-647-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAWAY",
        "first_name": "MARIA",
        "middle_name": "MADELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD463696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.