NPIMap

Individual provider Active NPI

Eric Samuel Hansen, D.O.

  • Internal Medicine Physician
  • Vernon, NJ
National Provider Identifier
1306823364
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB06308800 Issued in NJ
Practice address
212 Route 94
Suite 1-D
Vernon, NJ 07462
Phone
(973) 209-2162
Fax
(973) 209-2665
NPI assigned
Dec 29, 2005
Last updated
Feb 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB06308800 NJ Primary

Addresses

Primary practice location

212 Route 94
Suite 1-D
Vernon, NJ 07462

Mailing address

532 Lafayette Rd
Suite 300
Sparta, NJ 07871-4411
Phone (973) 940-0423

Other identifiers 1

IdentifierTypeStateIssuer
7575700MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081105000249 NJ Practitioner - Internal Medicine 9335105501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Associates LLCGroup PAC ID 0840283008, 45 clinicians

Practice addresses (Care Compare)

123 Newton Sparta Rd
Newton, NJ 07860-2769
Phone (973) 579-6300

225 State Route 23
Suite 1C
Hamburg, NJ 07419-1704
Phone (973) 383-1450

715 Route 10 E
Randolph, NJ 07869-2025
Phone (973) 343-7040

89 Sparta Ave
Sparta, NJ 07871-1777
Phone (973) 209-1550

89 Sparta Ave
Suite 100
Sparta, NJ 07871-1790
Phone (973) 729-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.05 of 100Reported as apm
Quality
65.09
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06308800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Associates LLC Internal Medicine CurrentSince Jul 1, 1997 Accepting new patients
Premier Health Associates, LLC CurrentSince Jul 1, 1997 Accepting new patients

Locations

123 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 579-1000

175 High St
Newton, NJ 07860
Phone (973) 383-2121

532 Lafayette Rd
Ste 300
Sparta, NJ 07871
Phone (973) 940-0423

212 Route 94
Ste 1-D
Vernon, NJ 07462
Phone (973) 209-2162

Interoperability endpoints

  • Direct secure messaging: ehansen98915@direct.ahsys.org
  • Direct secure messaging: erichansen@premiernj.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJHBA

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 7

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1306823364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 LAFAYETTE RD",
            "address_2": "SUITE 300",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714411",
            "telephone_number": "973-940-0423",
            "fax_number": "973-940-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 ROUTE 94",
            "address_2": "SUITE 1-D",
            "city": "VERNON",
            "state": "NJ",
            "postal_code": "07462",
            "telephone_number": "973-209-2162",
            "fax_number": "973-209-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "ERIC",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB06308800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7575700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, NJ

Sources for this page

Verify at the official NPI Registry.