Individual provider Active NPI

Joseph Hannan, M.D.

  • Interventional Cardiology Physician
  • Worcester, MA
National Provider Identifier
1275513822
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
205941 Issued in MA
Practice address
123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone
(508) 368-3130
Fax
(508) 368-3167
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 205941 MA Primary

Addresses

Primary practice location

123 Summer St Ste 290N
Worcester, MA 01608-1216

Mailing address

123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone (508) 368-3130

Other identifiers 1

IdentifierTypeStateIssuer
110001143AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050802000643 MA Practitioner - Cardiovascular Disease (Cardiology) 5193767408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting45
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205941MAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Cardiovascular Disease CurrentSince Oct 26, 2000 Accepting new patients
Atrius Health, Inc. CurrentSince May 1, 2022 Accepting new patients
Atrius Health, Inc. Cardiovascular Disease Current Accepting new patients
Atrius Health, Inc. Cardiovascular Disease CurrentSince May 1, 2022 Accepting new patients
VHS Acquisition Subsidiary Number 7 Inc Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

123 Summer St
Ste 290N
Worcester, MA 01608
Phone (508) 368-3130

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: joseph.hannan.npi1275513822.reliant@direct.optumcare.masshiway.net
  • Direct secure messaging: jhannan157711@direct.bilh.masshiway.net

Organizations & group practices 6

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 4

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1275513822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN",
        "first_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "205941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110001143A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.