Individual provider Active NPI

Cody Hanson, DO

  • Dermatology Physician
  • Saint Joseph, MO
National Provider Identifier
1306230784
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2019011259 Issued in MO
Practice address
5204 N Belt Hwy
Saint Joseph, MO 64506-1211
Phone
(816) 383-8180
Fax
(816) 233-3983
NPI assigned
Mar 24, 2015
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 2019011259 MO Primary

Addresses

Primary practice location

5204 N Belt Hwy
Saint Joseph, MO 64506-1211

Mailing address

5204 N Belt Hwy
Saint Joseph, MO 64506-1211
Phone (816) 838-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190821000499 MO Practitioner - Dermatology 7113222092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5204 N Belt Hwy Entrance a
Mosaic Life Care
St Joseph, MO 64506-1211
Phone (816) 383-8180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision57
Removal of skin lesions1079
Removal or shaving of skin growth53
Skin biopsy322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019011259MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center CurrentSince Jul 15, 2019 Accepting new patients
Heartland Regional Medical Center CurrentSince Jul 15, 2019 Accepting new patients

Locations

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1295

5204 N Belt Hwy
Ste A
Saint Joseph, MO 64506
Phone (816) 383-8180

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5204 N Belt Hwy
#A
Saint Joseph, MO 64506
Phone (816) 383-8180

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.

Hospital & facility affiliations 1

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1306230784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061211",
            "telephone_number": "816-838-8180",
            "fax_number": "816-233-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061211",
            "telephone_number": "816-383-8180",
            "fax_number": "816-233-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "CODY",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2019011259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.